ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2021 and some content may be unavailable. To unlock all content for 2021, please visit the archives.

Abstract: SA-OR46

Urinary VEGF as a Prognostic Biomarker of CKD in Premature Infants with Lung Disease

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

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

Group or Team Name

  • Preterm Erythropoietin Neuroprotection Trial Investigators
Background

Premature neonates are at risk for chronic kidney disease (CKD). Lung disease is an emerging risk factor for CKD in infants. Impaired angiogenesis may be implicated as it is required for both lung and kidney development, repair from injury, and perturbations contribute to CKD development. VEGF is a marker of angiogenesis. We hypothesize that urinary VEGF would be lower in infants with lung disease who go on to developed CKD.

Methods

Using data from the REPAIReD study (NCT01378273) an ancillary of the PENUT trial, we assessed urinary VEGF in 40 infants with severe lung disease defined by respiratory support or supplemental oxygen at 36 weeks post-menstrual age (PMA). We measured urinary VEGF at 30-34 weeks PMA. Our outcome measure was CKD at 22-26 months (estimated glomerular filtration rate <90 ml/min/1.73m2). Urinary VEGF was determined with electro-chemiluminescent multi-analyte ELISA (Mesoscale). We compared values using Spairo-Wilk testing and ROC analysis with Youden’s index.

Results

Fourteen infants (35%) developed CKD. Urinary VEGF at 30-34 weeks PMA was lower in infants that developed CKD (2.23 vs, 2.63 log pg/mL; p=0.004). The AUC for VEGF to predict CKD was 0.77 (95% CI 0.62-0.92, p=0.005). Using a likelihood ratio of 2.32, a threshold of 2.47 log pg/mL gives a sensitivity of 72% and specificity of 70%.(Figure 1)

Conclusion

In this small cohort of premature infants with severe lung disease, urinary VEGF levels were lower in premature infants who went on to developed CKD compared to similar neonates who did not develop CKD. Additional urinary VEGF analysis in this cohort is ongoing. Low urinary VEGF may be a marker of abnormal angiogenesis and vascular repair in the kidney. Our findings suggest that urinary VEGF may help predict CKD in premature infants with lung disease.

In infants with severe lung disease (A) those that develop CKD have lower urinary VEGF levels (p=0.004) and (B) urinary VEGF predicts CKD status with an AUC of 0.77 (p=0.005)

Funding

  • NIDDK Support