TITLE:
Urinary Kidney Injury Molocule-1 Level in Preterm Neonates with Respiratory Distress Syndrome
AUTHORS:
Maha Youssef, Manal Abdelsalam, Radwa Saeed, Alshimaa Mohamed
KEYWORDS:
Premature, Respiratory Distress Syndrome, Urinary Kidney Injury Molocule-1, Acute Kidney Injury
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.6 No.1,
March
3,
2016
ABSTRACT: Background: Despite recent advances in perinatal and
neonatal care in respiratory distress syndrome (RDS) prevention and treatment,
a considerable number of these neonates suffer from acute kidney injury (AKI),
and it is associated with poor outcome as an independent risk factor. KIM-1
mRNA and protein are expressed at a low level in normal kidney but are
increased in post ischemic kidney. Aim: The aim is to detect the value of
urinary KIM-1 measurement as an early predictor marker of acute kidney injury
in preterm neonates with respiratory distress syndrome. Patients and methods:
The study included 30 preterm newborn with (RDS) ≤36 weeks during the period
from October 2014 to March 2015. Also the study included 30 apparently healthy
newborn ≤36 weeks as controls. They were selected from NICU of Manshiate
Elbakry hospital Cairo, Egypt. uKIM-1 along with serum creatinine levels and
eGFR were assessed in days 1 of life for both groups and in day 3 for cases. Results:
In day one of life, we found a significant increase in uKIM-1 levels in preterm
newborn with RDS compared to their controls (2.88 ± 1.01 ng/ml and 0.95 ± 0.52
ng/ml respectively (p = 0.001)). There is no
significant difference between both groups regarding serum creatinine
and eGFR. In day 3 of life, preterm with RDS had significant decrease in uKIM-1
levels compared to day 1 of life with significant increase in non-survivor
compared to survivor group ( 2.30 ± 1.56 ng/ml and 1.30 ± 0.90 ng/ml
respectively (p = 0.03)). The sensitivity and specificity of uKIM-1 and serum
creatinine was calculated (100.00%, 86.67% and 33.33%; 95.00%) respectively.
Conclusion: Preterm neonate with RDS is at high risk of developing AKI. Early
and serial uKIM-1 measurements can be used as a non-invasive
indicator of kidney injury in premature newborn with RDS.