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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (01): 7 -14. doi: 10.3877/cma.j.issn.1673-5250.2021.01.002

Special Issue: ；

Forum

Current research status on biomarkers of neonatal acute kidney injury

Huiying Wang, Min Su†(), Xiangyu Gao   

  • Received:2020-09-11 Revised:2021-01-09 Published:2021-02-01
  • Corresponding author: Min Su
  • Supported by:
    Project of Jiangsu Youth Medical Talents(QNRC2016384)
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Neonatal acute kidney injury (AKI) refers to which kidney function is impaired for a variety of reasons in a short term. The neonates with AKI present a variety of pathological states, such as hypovolemic shock, hypoxia, hypothermia and so on, accompanied by an acute and reversible increment in serum creatinine level associated or not with a reduction in urine output, and resulting in derangements in water-electrolyte balance, acid-base and metabolic waste clearance. The manifestation of AKI is latent, so the neonates with AKI are easily miss diagnosed by clinics. The special pathophysiological characteristics of neonates with AKI are quite different from adult patients with AKI. Currently, the continuously improved diagnostic criteria for adult AKI are not suitable for diagnosis of neonates with AKI. Therefore, new biomarkers of kidney injury are needed for early prediction and auxiliary diagnosis of neonatal AKI. At present, the new biomarkers that can reflect renal tubular, glomerular injury and contribute to diagnosis of neonatal AKI include: cystatin C (Cys-C), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule (KIM)-1, β2-microglobulin (β2-MG), α1-microglobulin (α1-MG), N-acetyl-β-D-glucosaminidase (NAG), liver-type fatty acid-binding protein (L-FABP), axon guidance factor netrin (Netrin)-1, epidermal growth factor (EGF), interleukin (IL)-18, glutathione-S-transferase (GST) and β-trace protein (BTP), etc.. Among many new biomarkers for predicting neonatal AKI, the biomarkers which are more and better applied in clinic are urine or serum Cys-C, urine or serum NGAL, and urine KIM-1. In terms of early prediction and auxiliary diagnosis of neonatal AKI, they perform better than the detection of serum creatinine and urine output. However, their " normal value" is largely affected by many factors, such as gestational age, birth weight, postnatal age and systemic infection of newborns. These factors can reduce the sensitivity and specificity of predicting neonatal AKI. When multiple biomarkers are combined to predict neonatal AKI, the sensitivity can be improved in spite of reduced specificity of prediction.

Key words: Acute kidney injury, Biological markers, Cystatin C, Infant, newborn
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