Association Between Urinary Biomarkers and CKD in Extremely Low Gestational Age Neonates
Children born before 28 weeks’ gestation are at increased risk of chronic kidney disease (CKD). Urine biomarkers may shed light on mechanistic pathways and improve the ability to forecast CKD. We evaluated whether urinary biomarkers in neonates of low gestational age (GA) are associated with a reduc...
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| Veröffentlicht in: | American journal of kidney diseases 2024-04, Vol.83 (4), p.497-507 |
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| creator | Brophy, Patrick Heagerty, Patrick J. Juul, Sandra Thomas, Billy Mulrooney, Neil Kase, Jordan S. Gogcu, Semsa Ramel, Sara Georgieff, Michael Pfister, Katie Roberts, Kari Engel, Melissa Kamrath, Heidi Scheurer, Johannah Satrom, Katherine Pfister, Susan Plummer, Erin Williams, Jonathan Rajderkar, Dhanashree Northington, Frances Valdez, Raul Chavez Beauman, Sandra Saurabhkumar, Patel Serize, Arturo Ott, Debbie Mora, Ariana Franco Hedrick, Pamela Flynn, Vicki Feltner, John B. Esposito, Isabella Hauge, Stephanie Purnell, Andrea Sikes, Natalie Mason, Melanie McConnell, Jana Brown, Tiffany Pearson, Denise Guy, Annette Nason, Jennifer Lee, Kristen Penny, Sarah Richter, Tyler Ginder, Alexander Rau, Carrie McGrath, Kandace Lewis, Kimberlee Weaver Bird, Karie Giblin, Clare Daly, Rita Wassenaar, Jenna Ericksen, Jensina Davern, Bridget Osborne, Mary Pat Gregorich, Brittany Talele, Neha Obregon, Evelyn Ziyeh, Tiglath Clarke, Molly Barnhart, Lisa Galvis, Edshelee M. Martinez, Denise Bell, Suzi Long, Corrie McConkey, Stacy Natarajan, Niranjana Gaudette, Shari Cobb, Sarah Sharp, Gregory Schumacher, Elizabeth Schuschke, Leslie Fierro, Mario Gilmore, Lois Hoekstra, Ronald Cunningham, Sean Morshedzadeh, Galina Ostrander, Betsy Winter, Sarah Cox, Lauren Rainaldi, Matthew A. Hensley, Sarah Morris, Melissa Boys, Christopher Pierpont, Elizabeth I. King, Kelly E. Bergeron, Mark Miller, Cristina Marakovitz, Susan Knorr, Aimee Weissbourd, Marie Brady, Janet Ghosh, Suman Lowe, Jean Fuller, Janell DuPont, Tara Ohls, Robin Patel, Saurabh Carbonell, Lauren de Lerma, Carmen De Cortada, Maiana Chavis, Lacy |
| description | Children born before 28 weeks’ gestation are at increased risk of chronic kidney disease (CKD). Urine biomarkers may shed light on mechanistic pathways and improve the ability to forecast CKD. We evaluated whether urinary biomarkers in neonates of low gestational age (GA) are associated with a reduced estimated glomerular filtration rate (eGFR) over time.
A cohort study of neonates with an exploratory case-control study of a subset of the cohort.
327 neonates born at 24-27 weeks’ gestation with 2-year eGFR data from the PENUT (Preterm Erythropoietin Neuroprotection Trial) and the REPaIReD (Recombinant Erythropoietin for Prevention of Infant Renal Disease) study.
11 urinary biomarkers measured at 27, 30, and 34 weeks’ postmenstrual age for the primary cohort study and 10 additional biomarkers for the exploratory case-control study.
eGFR |
| doi_str_mv | 10.1053/j.ajkd.2023.09.008 |
| format | Article |
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Urine biomarkers may shed light on mechanistic pathways and improve the ability to forecast CKD. We evaluated whether urinary biomarkers in neonates of low gestational age (GA) are associated with a reduced estimated glomerular filtration rate (eGFR) over time.
A cohort study of neonates with an exploratory case-control study of a subset of the cohort.
327 neonates born at 24-27 weeks’ gestation with 2-year eGFR data from the PENUT (Preterm Erythropoietin Neuroprotection Trial) and the REPaIReD (Recombinant Erythropoietin for Prevention of Infant Renal Disease) study.
11 urinary biomarkers measured at 27, 30, and 34 weeks’ postmenstrual age for the primary cohort study and 10 additional biomarkers for the exploratory case-control study.
eGFR<90mL/min/1.73m2 at 2 years corrected for GA.
Linear mixed models to assess differences in biomarker values between neonates in whom CKD did and did not develop, accounting for multiple comparisons using Bonferroni-Holm correction in the cohort study only. Cohort analyses were adjusted for sex, GA, and body mass index. Cases were matched to controls on these variables in the case-control study.
After adjusting for weeks of GA, urinary levels of α-glutathione-S-transferase (log difference, 0.27; 95% CI, 0.12-0.43), albumin (log difference, 0.13; 95% CI, 0.02-0.25), and cystatin C (log difference, 0.19; 95% CI, 0.04-0.34) were higher in those in whom CKD developed than in those in whom it did not. Urinary albumin and cystatin C levels did not remain significantly different after Bonferroni-Holm correction. In the exploratory case-control analysis, there were no differences in any biomarkers between cases and controls.
Early deaths and a high number of subjects without eGFR at 2 years corrected for GA.
Measurement of urinary biomarkers may assist in monitoring neonates who are at risk for CKD. Additional studies are needed to confirm these findings.
Grants from government (National Institutes of Health).
Registered at ClinicalTrials.gov with study number NCT01378273.
Approximately 15 million neonates worldwide are born prematurely, and 2 million are born before 28 weeks’ gestation. Many of these children go on to experience chronic kidney disease. Urine biomarkers may allow for early recognition of those at risk for the development of kidney disease. In this study of more than 300 children born before 28 weeks’ gestational age, we found higher mean urinary levels of α-glutathione-S-transferase at 27, 30, and 34 weeks in children whose estimated glomerular filtration rate was<90mL/min/1.73m2 at 2 years compared with children whose estimated glomerular filtration rate was>90mL/min/1.73m2 at 2 years. Measurement of urinary biomarkers may assist in monitoring neonates who are at risk for chronic kidney disease. Additional studies are needed to confirm our findings.</description><identifier>ISSN: 0272-6386</identifier><identifier>ISSN: 1523-6838</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2023.09.008</identifier><identifier>PMID: 37926336</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Albumins ; Biomarkers - urine ; Case-Control Studies ; Child ; Cohort Studies ; Cystatin C ; Erythropoietin ; extreme prematurity, urinary biomarkers, chronic kidney disease ; Gestational Age ; Glomerular Filtration Rate ; Glutathione ; Humans ; Infant ; Infant, Newborn ; Renal Insufficiency, Chronic - complications ; Transferases</subject><ispartof>American journal of kidney diseases, 2024-04, Vol.83 (4), p.497-507</ispartof><rights>2023 National Kidney Foundation, Inc.</rights><rights>Copyright © 2023 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-4f81b42c05bb786c732f393879a79506a386310816658f6063160c0fbcf8c5c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2023.09.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37926336$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brophy, Patrick</creatorcontrib><creatorcontrib>Heagerty, Patrick J.</creatorcontrib><creatorcontrib>Juul, Sandra</creatorcontrib><creatorcontrib>Thomas, Billy</creatorcontrib><creatorcontrib>Mulrooney, Neil</creatorcontrib><creatorcontrib>Kase, Jordan S.</creatorcontrib><creatorcontrib>Gogcu, 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Aimee</creatorcontrib><creatorcontrib>Weissbourd, Marie</creatorcontrib><creatorcontrib>Brady, Janet</creatorcontrib><creatorcontrib>Ghosh, Suman</creatorcontrib><creatorcontrib>Lowe, Jean</creatorcontrib><creatorcontrib>Fuller, Janell</creatorcontrib><creatorcontrib>DuPont, Tara</creatorcontrib><creatorcontrib>Ohls, Robin</creatorcontrib><creatorcontrib>Patel, Saurabh</creatorcontrib><creatorcontrib>Carbonell, Lauren</creatorcontrib><creatorcontrib>de Lerma, Carmen</creatorcontrib><creatorcontrib>De Cortada, Maiana</creatorcontrib><creatorcontrib>Chavis, Lacy</creatorcontrib><creatorcontrib>PENUT Investigators</creatorcontrib><title>Association Between Urinary Biomarkers and CKD in Extremely Low Gestational Age Neonates</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Children born before 28 weeks’ gestation are at increased risk of chronic kidney disease (CKD). Urine biomarkers may shed light on mechanistic pathways and improve the ability to forecast CKD. We evaluated whether urinary biomarkers in neonates of low gestational age (GA) are associated with a reduced estimated glomerular filtration rate (eGFR) over time.
A cohort study of neonates with an exploratory case-control study of a subset of the cohort.
327 neonates born at 24-27 weeks’ gestation with 2-year eGFR data from the PENUT (Preterm Erythropoietin Neuroprotection Trial) and the REPaIReD (Recombinant Erythropoietin for Prevention of Infant Renal Disease) study.
11 urinary biomarkers measured at 27, 30, and 34 weeks’ postmenstrual age for the primary cohort study and 10 additional biomarkers for the exploratory case-control study.
eGFR<90mL/min/1.73m2 at 2 years corrected for GA.
Linear mixed models to assess differences in biomarker values between neonates in whom CKD did and did not develop, accounting for multiple comparisons using Bonferroni-Holm correction in the cohort study only. Cohort analyses were adjusted for sex, GA, and body mass index. Cases were matched to controls on these variables in the case-control study.
After adjusting for weeks of GA, urinary levels of α-glutathione-S-transferase (log difference, 0.27; 95% CI, 0.12-0.43), albumin (log difference, 0.13; 95% CI, 0.02-0.25), and cystatin C (log difference, 0.19; 95% CI, 0.04-0.34) were higher in those in whom CKD developed than in those in whom it did not. Urinary albumin and cystatin C levels did not remain significantly different after Bonferroni-Holm correction. In the exploratory case-control analysis, there were no differences in any biomarkers between cases and controls.
Early deaths and a high number of subjects without eGFR at 2 years corrected for GA.
Measurement of urinary biomarkers may assist in monitoring neonates who are at risk for CKD. Additional studies are needed to confirm these findings.
Grants from government (National Institutes of Health).
Registered at ClinicalTrials.gov with study number NCT01378273.
Approximately 15 million neonates worldwide are born prematurely, and 2 million are born before 28 weeks’ gestation. Many of these children go on to experience chronic kidney disease. Urine biomarkers may allow for early recognition of those at risk for the development of kidney disease. In this study of more than 300 children born before 28 weeks’ gestational age, we found higher mean urinary levels of α-glutathione-S-transferase at 27, 30, and 34 weeks in children whose estimated glomerular filtration rate was<90mL/min/1.73m2 at 2 years compared with children whose estimated glomerular filtration rate was>90mL/min/1.73m2 at 2 years. Measurement of urinary biomarkers may assist in monitoring neonates who are at risk for chronic kidney disease. Additional studies are needed to confirm our findings.</description><subject>Albumins</subject><subject>Biomarkers - urine</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Cystatin C</subject><subject>Erythropoietin</subject><subject>extreme prematurity, urinary biomarkers, chronic kidney disease</subject><subject>Gestational Age</subject><subject>Glomerular Filtration Rate</subject><subject>Glutathione</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Renal Insufficiency, Chronic - 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Janell</creator><creator>DuPont, Tara</creator><creator>Ohls, Robin</creator><creator>Patel, Saurabh</creator><creator>Carbonell, Lauren</creator><creator>de Lerma, Carmen</creator><creator>De Cortada, Maiana</creator><creator>Chavis, Lacy</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202404</creationdate><title>Association Between Urinary Biomarkers and CKD in Extremely Low Gestational Age Neonates</title><author>Brophy, Patrick ; Heagerty, Patrick J. ; Juul, Sandra ; Thomas, Billy ; Mulrooney, Neil ; Kase, Jordan S. ; Gogcu, Semsa ; Ramel, Sara ; Georgieff, Michael ; Pfister, Katie ; Roberts, Kari ; Engel, Melissa ; Kamrath, Heidi ; Scheurer, Johannah ; Satrom, Katherine ; Pfister, Susan ; Plummer, Erin ; Williams, Jonathan ; Rajderkar, Dhanashree ; Northington, Frances ; Valdez, Raul Chavez ; Beauman, Sandra ; Saurabhkumar, Patel ; Serize, Arturo ; Ott, Debbie ; Mora, Ariana Franco ; Hedrick, Pamela ; Flynn, Vicki ; Feltner, John B. ; Esposito, Isabella ; Hauge, Stephanie ; Purnell, Andrea ; Sikes, Natalie ; Mason, Melanie ; McConnell, Jana ; Brown, Tiffany ; Pearson, Denise ; Guy, Annette ; Nason, Jennifer ; Lee, Kristen ; Penny, Sarah ; Richter, Tyler ; Ginder, Alexander ; Rau, Carrie ; McGrath, Kandace ; Lewis, Kimberlee Weaver ; Bird, Karie ; Giblin, Clare ; Daly, Rita ; Wassenaar, Jenna ; Ericksen, Jensina ; Davern, Bridget ; Osborne, Mary Pat ; Gregorich, Brittany ; Talele, Neha ; Obregon, Evelyn ; Ziyeh, Tiglath ; Clarke, Molly ; Barnhart, Lisa ; Galvis, Edshelee M. ; Martinez, Denise ; Bell, Suzi ; Long, Corrie ; McConkey, Stacy ; Natarajan, Niranjana ; Gaudette, Shari ; Cobb, Sarah ; Sharp, Gregory ; Schumacher, Elizabeth ; Schuschke, Leslie ; Fierro, Mario ; Gilmore, Lois ; Hoekstra, Ronald ; Cunningham, Sean ; Morshedzadeh, Galina ; Ostrander, Betsy ; Winter, Sarah ; Cox, Lauren ; Rainaldi, Matthew A. ; Hensley, Sarah ; Morris, Melissa ; Boys, Christopher ; Pierpont, Elizabeth I. ; King, Kelly E. ; Bergeron, Mark ; Miller, Cristina ; Marakovitz, Susan ; Knorr, Aimee ; Weissbourd, Marie ; Brady, Janet ; Ghosh, Suman ; Lowe, Jean ; Fuller, Janell ; DuPont, Tara ; Ohls, Robin ; Patel, Saurabh ; Carbonell, Lauren ; de Lerma, Carmen ; De Cortada, Maiana ; Chavis, Lacy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-4f81b42c05bb786c732f393879a79506a386310816658f6063160c0fbcf8c5c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Albumins</topic><topic>Biomarkers - urine</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Cystatin C</topic><topic>Erythropoietin</topic><topic>extreme prematurity, urinary biomarkers, chronic kidney disease</topic><topic>Gestational Age</topic><topic>Glomerular Filtration Rate</topic><topic>Glutathione</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Transferases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brophy, Patrick</creatorcontrib><creatorcontrib>Heagerty, Patrick J.</creatorcontrib><creatorcontrib>Juul, Sandra</creatorcontrib><creatorcontrib>Thomas, Billy</creatorcontrib><creatorcontrib>Mulrooney, Neil</creatorcontrib><creatorcontrib>Kase, Jordan S.</creatorcontrib><creatorcontrib>Gogcu, Semsa</creatorcontrib><creatorcontrib>Ramel, Sara</creatorcontrib><creatorcontrib>Georgieff, Michael</creatorcontrib><creatorcontrib>Pfister, Katie</creatorcontrib><creatorcontrib>Roberts, Kari</creatorcontrib><creatorcontrib>Engel, Melissa</creatorcontrib><creatorcontrib>Kamrath, Heidi</creatorcontrib><creatorcontrib>Scheurer, Johannah</creatorcontrib><creatorcontrib>Satrom, Katherine</creatorcontrib><creatorcontrib>Pfister, Susan</creatorcontrib><creatorcontrib>Plummer, Erin</creatorcontrib><creatorcontrib>Williams, Jonathan</creatorcontrib><creatorcontrib>Rajderkar, Dhanashree</creatorcontrib><creatorcontrib>Northington, Frances</creatorcontrib><creatorcontrib>Valdez, Raul Chavez</creatorcontrib><creatorcontrib>Beauman, Sandra</creatorcontrib><creatorcontrib>Saurabhkumar, Patel</creatorcontrib><creatorcontrib>Serize, Arturo</creatorcontrib><creatorcontrib>Ott, Debbie</creatorcontrib><creatorcontrib>Mora, Ariana Franco</creatorcontrib><creatorcontrib>Hedrick, Pamela</creatorcontrib><creatorcontrib>Flynn, Vicki</creatorcontrib><creatorcontrib>Feltner, John B.</creatorcontrib><creatorcontrib>Esposito, Isabella</creatorcontrib><creatorcontrib>Hauge, Stephanie</creatorcontrib><creatorcontrib>Purnell, Andrea</creatorcontrib><creatorcontrib>Sikes, Natalie</creatorcontrib><creatorcontrib>Mason, Melanie</creatorcontrib><creatorcontrib>McConnell, Jana</creatorcontrib><creatorcontrib>Brown, Tiffany</creatorcontrib><creatorcontrib>Pearson, Denise</creatorcontrib><creatorcontrib>Guy, Annette</creatorcontrib><creatorcontrib>Nason, Jennifer</creatorcontrib><creatorcontrib>Lee, Kristen</creatorcontrib><creatorcontrib>Penny, Sarah</creatorcontrib><creatorcontrib>Richter, Tyler</creatorcontrib><creatorcontrib>Ginder, Alexander</creatorcontrib><creatorcontrib>Rau, Carrie</creatorcontrib><creatorcontrib>McGrath, Kandace</creatorcontrib><creatorcontrib>Lewis, Kimberlee Weaver</creatorcontrib><creatorcontrib>Bird, Karie</creatorcontrib><creatorcontrib>Giblin, Clare</creatorcontrib><creatorcontrib>Daly, Rita</creatorcontrib><creatorcontrib>Wassenaar, Jenna</creatorcontrib><creatorcontrib>Ericksen, Jensina</creatorcontrib><creatorcontrib>Davern, Bridget</creatorcontrib><creatorcontrib>Osborne, Mary Pat</creatorcontrib><creatorcontrib>Gregorich, Brittany</creatorcontrib><creatorcontrib>Talele, Neha</creatorcontrib><creatorcontrib>Obregon, Evelyn</creatorcontrib><creatorcontrib>Ziyeh, Tiglath</creatorcontrib><creatorcontrib>Clarke, Molly</creatorcontrib><creatorcontrib>Barnhart, Lisa</creatorcontrib><creatorcontrib>Galvis, Edshelee M.</creatorcontrib><creatorcontrib>Martinez, Denise</creatorcontrib><creatorcontrib>Bell, Suzi</creatorcontrib><creatorcontrib>Long, Corrie</creatorcontrib><creatorcontrib>McConkey, Stacy</creatorcontrib><creatorcontrib>Natarajan, Niranjana</creatorcontrib><creatorcontrib>Gaudette, Shari</creatorcontrib><creatorcontrib>Cobb, Sarah</creatorcontrib><creatorcontrib>Sharp, Gregory</creatorcontrib><creatorcontrib>Schumacher, Elizabeth</creatorcontrib><creatorcontrib>Schuschke, Leslie</creatorcontrib><creatorcontrib>Fierro, Mario</creatorcontrib><creatorcontrib>Gilmore, Lois</creatorcontrib><creatorcontrib>Hoekstra, Ronald</creatorcontrib><creatorcontrib>Cunningham, Sean</creatorcontrib><creatorcontrib>Morshedzadeh, Galina</creatorcontrib><creatorcontrib>Ostrander, Betsy</creatorcontrib><creatorcontrib>Winter, Sarah</creatorcontrib><creatorcontrib>Cox, Lauren</creatorcontrib><creatorcontrib>Rainaldi, Matthew A.</creatorcontrib><creatorcontrib>Hensley, Sarah</creatorcontrib><creatorcontrib>Morris, Melissa</creatorcontrib><creatorcontrib>Boys, Christopher</creatorcontrib><creatorcontrib>Pierpont, Elizabeth I.</creatorcontrib><creatorcontrib>King, Kelly E.</creatorcontrib><creatorcontrib>Bergeron, Mark</creatorcontrib><creatorcontrib>Miller, Cristina</creatorcontrib><creatorcontrib>Marakovitz, Susan</creatorcontrib><creatorcontrib>Knorr, Aimee</creatorcontrib><creatorcontrib>Weissbourd, Marie</creatorcontrib><creatorcontrib>Brady, Janet</creatorcontrib><creatorcontrib>Ghosh, Suman</creatorcontrib><creatorcontrib>Lowe, Jean</creatorcontrib><creatorcontrib>Fuller, Janell</creatorcontrib><creatorcontrib>DuPont, Tara</creatorcontrib><creatorcontrib>Ohls, Robin</creatorcontrib><creatorcontrib>Patel, Saurabh</creatorcontrib><creatorcontrib>Carbonell, Lauren</creatorcontrib><creatorcontrib>de Lerma, Carmen</creatorcontrib><creatorcontrib>De Cortada, Maiana</creatorcontrib><creatorcontrib>Chavis, Lacy</creatorcontrib><creatorcontrib>PENUT Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brophy, Patrick</au><au>Heagerty, Patrick J.</au><au>Juul, Sandra</au><au>Thomas, Billy</au><au>Mulrooney, Neil</au><au>Kase, Jordan S.</au><au>Gogcu, Semsa</au><au>Ramel, Sara</au><au>Georgieff, Michael</au><au>Pfister, Katie</au><au>Roberts, Kari</au><au>Engel, Melissa</au><au>Kamrath, Heidi</au><au>Scheurer, Johannah</au><au>Satrom, Katherine</au><au>Pfister, Susan</au><au>Plummer, Erin</au><au>Williams, Jonathan</au><au>Rajderkar, Dhanashree</au><au>Northington, Frances</au><au>Valdez, Raul Chavez</au><au>Beauman, Sandra</au><au>Saurabhkumar, Patel</au><au>Serize, Arturo</au><au>Ott, Debbie</au><au>Mora, Ariana Franco</au><au>Hedrick, Pamela</au><au>Flynn, Vicki</au><au>Feltner, John B.</au><au>Esposito, Isabella</au><au>Hauge, Stephanie</au><au>Purnell, Andrea</au><au>Sikes, Natalie</au><au>Mason, Melanie</au><au>McConnell, Jana</au><au>Brown, Tiffany</au><au>Pearson, Denise</au><au>Guy, Annette</au><au>Nason, Jennifer</au><au>Lee, Kristen</au><au>Penny, Sarah</au><au>Richter, Tyler</au><au>Ginder, Alexander</au><au>Rau, Carrie</au><au>McGrath, Kandace</au><au>Lewis, Kimberlee Weaver</au><au>Bird, Karie</au><au>Giblin, Clare</au><au>Daly, Rita</au><au>Wassenaar, Jenna</au><au>Ericksen, Jensina</au><au>Davern, Bridget</au><au>Osborne, Mary Pat</au><au>Gregorich, Brittany</au><au>Talele, Neha</au><au>Obregon, Evelyn</au><au>Ziyeh, Tiglath</au><au>Clarke, Molly</au><au>Barnhart, Lisa</au><au>Galvis, Edshelee M.</au><au>Martinez, Denise</au><au>Bell, Suzi</au><au>Long, Corrie</au><au>McConkey, Stacy</au><au>Natarajan, Niranjana</au><au>Gaudette, Shari</au><au>Cobb, Sarah</au><au>Sharp, Gregory</au><au>Schumacher, Elizabeth</au><au>Schuschke, Leslie</au><au>Fierro, Mario</au><au>Gilmore, Lois</au><au>Hoekstra, Ronald</au><au>Cunningham, Sean</au><au>Morshedzadeh, Galina</au><au>Ostrander, Betsy</au><au>Winter, Sarah</au><au>Cox, Lauren</au><au>Rainaldi, Matthew A.</au><au>Hensley, Sarah</au><au>Morris, Melissa</au><au>Boys, Christopher</au><au>Pierpont, Elizabeth I.</au><au>King, Kelly E.</au><au>Bergeron, Mark</au><au>Miller, Cristina</au><au>Marakovitz, Susan</au><au>Knorr, Aimee</au><au>Weissbourd, Marie</au><au>Brady, Janet</au><au>Ghosh, Suman</au><au>Lowe, Jean</au><au>Fuller, Janell</au><au>DuPont, Tara</au><au>Ohls, Robin</au><au>Patel, Saurabh</au><au>Carbonell, Lauren</au><au>de Lerma, Carmen</au><au>De Cortada, Maiana</au><au>Chavis, Lacy</au><aucorp>PENUT Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Urinary Biomarkers and CKD in Extremely Low Gestational Age Neonates</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2024-04</date><risdate>2024</risdate><volume>83</volume><issue>4</issue><spage>497</spage><epage>507</epage><pages>497-507</pages><issn>0272-6386</issn><issn>1523-6838</issn><eissn>1523-6838</eissn><abstract>Children born before 28 weeks’ gestation are at increased risk of chronic kidney disease (CKD). Urine biomarkers may shed light on mechanistic pathways and improve the ability to forecast CKD. We evaluated whether urinary biomarkers in neonates of low gestational age (GA) are associated with a reduced estimated glomerular filtration rate (eGFR) over time.
A cohort study of neonates with an exploratory case-control study of a subset of the cohort.
327 neonates born at 24-27 weeks’ gestation with 2-year eGFR data from the PENUT (Preterm Erythropoietin Neuroprotection Trial) and the REPaIReD (Recombinant Erythropoietin for Prevention of Infant Renal Disease) study.
11 urinary biomarkers measured at 27, 30, and 34 weeks’ postmenstrual age for the primary cohort study and 10 additional biomarkers for the exploratory case-control study.
eGFR<90mL/min/1.73m2 at 2 years corrected for GA.
Linear mixed models to assess differences in biomarker values between neonates in whom CKD did and did not develop, accounting for multiple comparisons using Bonferroni-Holm correction in the cohort study only. Cohort analyses were adjusted for sex, GA, and body mass index. Cases were matched to controls on these variables in the case-control study.
After adjusting for weeks of GA, urinary levels of α-glutathione-S-transferase (log difference, 0.27; 95% CI, 0.12-0.43), albumin (log difference, 0.13; 95% CI, 0.02-0.25), and cystatin C (log difference, 0.19; 95% CI, 0.04-0.34) were higher in those in whom CKD developed than in those in whom it did not. Urinary albumin and cystatin C levels did not remain significantly different after Bonferroni-Holm correction. In the exploratory case-control analysis, there were no differences in any biomarkers between cases and controls.
Early deaths and a high number of subjects without eGFR at 2 years corrected for GA.
Measurement of urinary biomarkers may assist in monitoring neonates who are at risk for CKD. Additional studies are needed to confirm these findings.
Grants from government (National Institutes of Health).
Registered at ClinicalTrials.gov with study number NCT01378273.
Approximately 15 million neonates worldwide are born prematurely, and 2 million are born before 28 weeks’ gestation. Many of these children go on to experience chronic kidney disease. Urine biomarkers may allow for early recognition of those at risk for the development of kidney disease. In this study of more than 300 children born before 28 weeks’ gestational age, we found higher mean urinary levels of α-glutathione-S-transferase at 27, 30, and 34 weeks in children whose estimated glomerular filtration rate was<90mL/min/1.73m2 at 2 years compared with children whose estimated glomerular filtration rate was>90mL/min/1.73m2 at 2 years. Measurement of urinary biomarkers may assist in monitoring neonates who are at risk for chronic kidney disease. Additional studies are needed to confirm our findings.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37926336</pmid><doi>10.1053/j.ajkd.2023.09.008</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2024-04, Vol.83 (4), p.497-507 |
| issn | 0272-6386 1523-6838 1523-6838 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2886598720 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Albumins Biomarkers - urine Case-Control Studies Child Cohort Studies Cystatin C Erythropoietin extreme prematurity, urinary biomarkers, chronic kidney disease Gestational Age Glomerular Filtration Rate Glutathione Humans Infant Infant, Newborn Renal Insufficiency, Chronic - complications Transferases |
| title | Association Between Urinary Biomarkers and CKD in Extremely Low Gestational Age Neonates |
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