Gubhaju, Lina

Sutherland, Megan R

Horne, Rosemary S C

Medhurst, Alison

Kent, Alison L

Ramsden, Andrew

Moore, Lynette

Singh, Gurmeet

Hoy, Wendy E

Black, M Jane

2014-07-15

Worldwide, approximately 10% of neonates are born preterm. The majority of preterm neonates are born when the kidneys are still developing; therefore, during the early postnatal period renal function is likely reflective of renal immaturity and/or injury. This study evaluated glomerular and tubular function and urinary neutrophil gelatinase-associated lipocalin (NGAL; a marker of renal injury) in preterm neonates during the first month of life. Preterm and term infants were recruited from Monash Newborn (neonatal intensive care unit at Monash Medical Centre) and Jesse McPherson Private Hospital, respectively. Infants were grouped according to gestational age at birth: ≤28 wk (n = 33), 29-31 wk (n = 44), 32-36 wk (n = 32), and term (≥37 wk (n = 22)). Measures of glomerular and tubular function were assessed on postnatal days 3-7, 14, 21, and 28. Glomerular and tubular function was significantly affected by gestational age at birth, as well as by postnatal age. By postnatal day 28, creatinine clearance remained significantly lower among preterm neonates compared with term infants; however, sodium excretion was not significantly different. Pathological proteinuria and high urinary NGAL levels were observed in a number of neonates, which may be indicative of renal injury; however, there was no correlation between the two markers. Findings suggest that neonatal renal function is predominantly influenced by renal maturity, and there was high capacity for postnatal tubular maturation among preterm neonates. There is insufficient evidence to suggest that urinary NGAL is a useful marker of renal injury in the preterm neonate.

Preventative Health, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia;.

Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia;.

Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Clayton, Victoria, Australia;.

Monash Newborn, Monash Medical Centre, Clayton, Victoria, Australia;.

Department of Neonatology, Canberra Hospital, and the Australian National University Medical School, Canberra, Australian Capital Territory, Australia;.

Monash Newborn, Monash Medical Centre, Clayton, Victoria, Australia;.

Department of Surgical Pathology, South Australia Pathology, Women's and Children's Hospital, North Adelaide and the University of Adelaide, Adelaide, South Australia, Australia;.

Menzies School of Health Research and the Royal Darwin Hospital, Casuarina, Northern Territory, Australia; and..

Centre for Chronic Disease, University of Queensland, Brisbane, Queensland, Australia..

Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia; Jane.Black@monash.edu..

American journal of physiology. Renal physiology 2014-07-15; 307(2): F149-58

https://pubmed.ncbi.nlm.nih.gov/24899060/?otool=iaurydwlib

https://hdl.handle.net/10137/5587

preterm birth

proteinuria

renal development

renal injury

Acute Kidney Injury

Acute-Phase Proteins

Age Factors

Biomarkers

Creatinine

Gestational Age

Glomerular Filtration Rate

Humans

Infant, Extremely Premature

Infant, Newborn

Kidney Glomerulus

Kidney Tubules

Lipocalin-2

Lipocalins

Models, Biological

Proteinuria

Proto-Oncogene Proteins

Victoria

Infant, Premature

Assessment of renal functional maturation and injury in preterm neonates during the first month of life.

Journal Article

Publication