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

Gubhaju, Lina, Sutherland, Megan R., Horne, Rosemary S. C., Medhurst, Alison, Kent, Alison L., Ramsden, Andrew, Moore, Lynette, Singh, Gurmeet, Hoy, Wendy E. and Black, M. Jane (2014) Assessment of renal functional maturation and injury in preterm neonates during the first month of life. American Journal of Physiology: Renal Physiology, 307 2: F149-F158. doi:10.1152/ajprenal.00439.2013

Author 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
Title Assessment of renal functional maturation and injury in preterm neonates during the first month of life
Journal name American Journal of Physiology: Renal Physiology   Check publisher's open access policy
ISSN 1931-857X
Publication date 2014-07-15
Year available 2014
Sub-type Article (original research)
DOI 10.1152/ajprenal.00439.2013
Open Access Status
Volume 307
Issue 2
Start page F149
End page F158
Total pages 10
Place of publication Bethesda, MD United States
Publisher American Physiological Society
Language eng
Subject 1314 Physiology
2748 Urology
Abstract 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.
Keyword Preterm birth
Renal development
Renal injury
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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