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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.

Document type: Journal Article
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IRMA ID 75039815xPUB259
Title Assessment of renal functional maturation and injury in preterm neonates during the first month of life
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
Journal Name American Journal of Physiology: Renal Physiology
Publication Date 2014
Volume Number 307
Issue Number 2
ISSN 1931-857X   (check CDU catalogue  open catalogue search in new window)
Start Page F149
End Page F158
Total Pages 10
Place of Publication United States of America
Publisher American Physiological Society
HERDC Category C1 - Journal Article (DIISR)
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.
Keywords Renal development
Preterm birth
Renal injury
Proteinuria
DOI http://dx.doi.org/10.1152/ajprenal.00439.2013   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Description for Link Link to publisher's version
URL http://ajprenal.physiology.org/content/307/2/F149
 
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