Early urinary angiotensinogen excretion in critically ill neonates
Early urinary angiotensinogen excretion in critically ill neonates
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DOI：
10.1177/1470320315583777
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发表时间：
2015-06
影响因子：
2.9
通讯作者：
Qing Wang;Mengxia Li;Xiaozhong Li;Jian Pan;Jian Wang;Xing Feng;Yanhong Li
中科院分区：
文献类型：
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作者：
Qing Wang;Mengxia Li;Xiaozhong Li;Jian Pan;Jian Wang;Xing Feng;Yanhong Li
引言：尿血管紧张素原被认为是肾内肾素-血管紧张素系统活性的可靠生物标志物。本研究的目的是评估危重新生儿出生后第一天的尿血管紧张素原水平，并评估其与肾功能的相关性。方法：测定98例危重新生儿出生后24小时尿血管紧张素原浓度。通过尿胱抑素C、尿白蛋白、尿α1-微球蛋白和尿电解质排泄量评估新生儿肾功能。结果：危重新生儿尿血管紧张素原水平随胎龄和体重的增加而降低（P<0.001）。校正胎龄后，尿血管紧张素原水平与尿钠排泄分数、尿胱抑素C和α1-微球蛋白水平相关。多元线性回归分析表明，尿胱抑素C对尿血管紧张素原水平有显著影响（P<0.001）。此外，尿半胱氨酸蛋白酶抑制剂-C-肌酐比值> 2500 ng/mg的新生儿尿血管紧张素原显著增加，这是我们先前研究中预测急性肾损伤的最佳临界值。结论：尿血管紧张素原水平与危重新生儿出生后早期肾功能的总体成熟度相关，尿血管紧张素原水平升高可能反映了未成熟新生儿的肾损伤。
Introduction: Urinary angiotensinogen is considered a reliable biomarker for intrarenal renin–angiotensin system activity. The aims of this study were to assess the urinary angiotensinogen level during the first day of life and to evaluate its correlation with renal function in critically ill neonates. Methods: Urinary angiotensinogen concentration during the first 24 hours of life was measured in 98 critically ill neonates. Neonatal renal function was assessed by urinary levels of cystatin-C, albumin and α1-microglobulin and urinary electrolyte excretion. Results: Urinary angiotensinogen level decreased with increasing gestational age and body weight in critically ill neonates (P<0.001). After adjustment for gestational age, urinary angiotensinogen level correlated with urinary fractional excretion of sodium and urinary levels of cystatin-C and α1-microglobulin. Multivariate linear regression identified a significant impact of urinary cystatin-C on urinary angiotensinogen level (P<0.001). Furthermore, urinary angiotensinogen was significantly increased in neonates with a urinary cystatin-C-to-creatinine ratio ⩾2500 ng/mg, which was the optimal cut-off value to predict acute kidney injury in our previous study. Conclusions: The urinary angiotensinogen level correlates with the overall maturity of renal function during the early postnatal period in critically ill neonates and an increased urinary angiotensinogen level might reflect renal injury in immature neonates.