Urinary Neutrophil Gelatinase-Associated Lipocalin Values in Preterm Neonates: A Systematic Review and Meta-analysis

Abstract

Objective

Acute kidney injury (AKI) is common in hospitalized preterm neonates. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a promising noninvasive AKI biomarker. However, normal values of uNGAL in preterm neonates without AKI are poorly characterized. The objective of this study was to evaluate the current literature to determine normal uNGAL values for preterm neonates without AKI.

Study Design

Systematic review and meta-analysis of all articles published before November 2021 evaluating uNGAL values in preterm neonates without AKI.

Results

Of 1,607 studies evaluated for eligibility, 11 were included in the final meta-analysis (210 males, 202 females). uNGAL values were higher in the preterm neonates <29 weeks and ranged between 20.7 and 782.65 ng/mL. Meta mean estimates of gestational age (GA), birthweight, and neutrophil gelatinase-associated lipocalin were 29.4 weeks (95% confidence interval [CI]: 28.8–30.0), 1,241 g (95% CI: 1,111–1,372), and 148.9 ng/mL (95% CI: 48–231), respectively.

Conclusion

In limited studies, a wide range of uNGAL values in preterm neonates without AKI are reported. Future studies should identify normal uNGAL values in preterm neonates using larger cohorts by GA and birthweight.

Key Points

• Urinary NGAL is a promising noninvasive biomarker of neonatal AKI.

• A wide range of uNGAL is reported in preterm neonates but the baseline values are not well defined.

• Urine NGAL values are higher in extremely preterm compared with preterm neonates.

Keywords

NGAL - neonatal AKI - acute kidney injury - urine NGAL - urinary NGAL

Publication History

Received: 29 March 2024

Accepted: 17 September 2024

Article published online:
22 October 2024

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