Background: Currently used biomarkers for acute kidney injury (AKI), namely Ngal, SCr, and BUN, are\r\ninadequate for timely detection of AKI in preterm infants.\r\nMethods: Nuclear magnetic resonance (NMR) spectroscopy-based metabolic profiling was conducted on urines\r\nfrom 20 preterm infants to determine if novel metabolic biomarkers could be identified for early detection of AKI.\r\nUrines were collected from every patient each day for the first 14 days of life. NMR spectra were measured for all\r\nurines and metabolic profiling analysis conducted.\r\nResults: One metabolite, carnitine, increased significantly in urines of three extremely low birth weight (ELBW)\r\ninfants starting on day five of life. The three affected infants either received prolonged antibiotic treatment, extended\r\ntreatment with indomethacin, or both. One ELBW patient who received both treatments and reached the highest\r\nurinary carnitine level died on day 10 of life due to localized gut perforation complicated by suspected AKI.\r\nConclusions: It was concluded that carnitine increased in the three neonates in part due to antibiotic- and/\r\nor indomethacin-induced AKI. It is hypothesized that combined antibiotic and indomethacin treatment promoted\r\nAKI resulting in reduced proximal renal tubule reabsorption of carnitine and that �Ÿ-lactam antibiotics blocked renal\r\ncarnitine uptake by human organic cation transporter, hOCTN2.
Loading....