ArticlePediatric nephrology (Berlin, Germany)2021
Urinary neutrophil gelatinase-associated lipocalin rules out nephrotoxic acute kidney injury in children.
Article in Pediatric nephrology (Berlin, Germany), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 24 citations in OpenAlex.
- Effect of Ibuprofen on Markers of Acute Kidney Injury, Intestinal Injury, and Endotoxemia after Running in the Heat.Medicine and science in sports and exercise · 2025Trial
- Research progress on biomarkers for acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2026Review
- Nephrotoxicity and kidney outcomes in pediatric oncology patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Novel Kidney Biomarkers and Antibiotics-Induced Acute Kidney Injury: A Practical Assessment of Current and Future Applications.Clinical and translational science · 2025Review
- The promise of biomarkers: precision medicine will pave a roadmap for pediatric acute kidney injury management in critically ill children.Intensive care medicine. Paediatric and neonatal · 2025Review
- Use of urine neutrophil gelatinase-associated lipocalin for nephrotoxic medication acute kidney injury screening in neonates.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Recommendations for clinical trial design in acute kidney injury from the 31st acute disease quality initiative consensus conference. A consensus statement.Intensive care medicine · 2024Article
- [Recent developments in acute kidney injury : Definition, biomarkers, subphenotypes, and management].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Article
- Acute kidney injury biomarker olfactomedin 4 predicts furosemide responsiveness.Pediatric nephrology (Berlin, Germany) · 2023Article
- uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children.Healthcare (Basel, Switzerland) · 2022Article
- Improving acute kidney injury diagnostic precision using biomarkers.Practical laboratory medicine · 2022Review
- Urine Sediment Exam Provides More Diagnostic Information in AKI than Novel Urinary Biomarkers: CON.Kidney360 · 2022Article
- Current Concepts of Pediatric Acute Kidney Injury-Are We Ready to Translate Them into Everyday Practice?Journal of clinical medicine · 2021Review
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNephrotoxic medication exposure is a common cause of acute kidney injury (AKI) in hospitalized children. A key component of the NINJA quality improvement initiative is systematic daily serum creatinine assessment in non-critically ill children exposed to ≥ 3 nephrotoxic medications on 1 day, or intravenous aminoglycoside or vancomycin for ≥ 3 days. Daily venipuncture is invasive and associated with disposable and personnel healthcare costs. Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a marker of renal tubular injury associated with certain nephrotoxic medications. We investigated whether uNGAL is a reliable screening tool for AKI in NINJA and could decrease the need for daily venipuncture.
methodsThis two-center prospective study enrolled 113 children who met NINJA criteria from May 2018 through March 2019. Daily urine samples were obtained for up to the first 7 days of qualifying exposure and 2 days after exposure ended. Our primary outcome was severe AKI (KDIGO stage 2 or 3 AKI). Maximum uNGAL was highest concentration on the day of, or 3 days prior to, severe AKI. The highest uNGAL level from all assessment days was used for patients who did not develop AKI or severe AKI.
resultsUrine NGAL thresholds of 150 and 300 ng/ml demonstrated excellent specificity (92.4 and 97.1% respectively) and negative predictive values (93.3 and 92.8% respectively) for ruling out severe AKI.
conclusionsWe suggest that uNGAL could be used to supplant some of the daily serum creatinine venipunctures in NINJA. The most optimal combination of serum creatinine and uNGAL assessment requires further study.
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