Factors Limiting Usefulness of Serum and Urinary NGAL As a Marker of Acute Kidney Injury in Preterm Newborns.

Background and aims Neutrophile gelatinase-associated lipocaline (NGAL) is postulated to be a highly sensitive and specific marker of acute kidney injury (AKI). The aim of this study was to assess the factors affecting serum and urine total NGAL in preterm newborns, limiting the role of this new potential marker of AKI. Methods Serum and urinary total NGAL concentrations were determined in 57 admitted to the Neonatal Intensive Care Unit preterm infants in the following points of time: first week of life, between 8 and 14 day of life, and after the fourth week of life. Patients’ clinical condition was evaluated based on NTISS (Neonatal Therapeutic Intervention Scoring System). Two gestational age subgroups were distinguished: <30 and 30 to 35 weeks of gestation. We seek correlation between total NGAL values and gestational age, birth weight, Apgar score and severity of clinical condition with particular interest in inflammatory status. Results Serum and urinary total NGAL concentration correlated with inflammatory markers, such as CRP and procalcitonin as well as with NTISS values. Birth weight and gestational age influence uNGAL values in the first two weeks of life. In AKI (N=8) patients uNGAL values were significantly higher than in non-AKI newborns. Conclusions We conclude that inflammatory status and prematurity limits the specificity of total NGAL measurement as the marker of AKI. Acknowledgement This study was supported by the grant from Medical University of Silesia (KNW–1–057/P/2/0).