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Abstract: PO2290

Gestational Age (GA) Affects Urine Biomarkers by Postnatal Age but Most Converge by 34 Weeks Post-Menstrual Age (PMA)

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Askenazi, David J., The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States
  • Halloran, Brian A., The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States
  • Schmicker, Robert, University of Washington, Seattle, Washington, United States
  • Heagerty, Patrick James, University of Washington, Seattle, Washington, United States
  • Juul, Sandra, University of Washington, Seattle, Washington, United States
  • Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Hingorani, Sangeeta R., University of Washington, Seattle, Washington, United States

Group or Team Name

  • PENUT Investigators
Background

Urine biomarkers may improve our understanding of kidney development and disease in premature neonates. We evalute how 1-week differences in GA impact 11 biomarkers by postnatal age and PMA.

Methods

Neonates were grouped by GA. Urine was collected on postnatal days 1, 3, 5, 7, 9, 14, 28; on PMA of 30 and 34 weeks; and discharge in 750 neonates without stage 2/3 AKI. Neutrophil-gelatinase associated lipocalin (NGAL), Clusterin, kidney injury molecule 1 (KIM-1), alpha glutathione S-Transferase (a-GST), albumin, beta-2-microglobulin (B2M), cystatin c, epithelial growth factor (EGF), osteopontin (OPN), uromodulin (UMOD), were evaluated by electrochemiluminescence; creatinine by mass spectrometer. Biomarkers are displayed as 7-day rolling mean (day X ± 3 days) on log10 scale. GEE models with mother as a clustering variable were used to determine the association between day, GA, and day*GA for each biomarker. T-tests evaluated differences in 34-week (± 3 day) PMA values.

Results

Figure: Left side plot biomarkers by postnatal age; right side plot biomarkers by PMA. When exploring the values by postnatal age, the most premature neonates have higher NGAL, clusterin, KIM-1, aGST, albumin, B2M, Cystatin C, OPN, and lower EGF, UMOD and Creatinine (p<0.05; * in Figure) after adjusting for day. The association of biomarker and time is significantly modified by GA for aGST, Albumin, B2M, Creatinine and Cystatin C (interaction term p<0.05; ** in Figure) over the first 30 postnatal days. Only B2M and OPN differ by GA at 34 weeks PMA (p<0.05; *** in Figure).

Conclusion

Urine biomarkers differ and are modified by GA during first 30 postnatal days. Most biomarkers converge and are not significantly different by 34 weeks PMA.

Funding

  • NIDDK Support