Urinary neutrophil gelatinase-associated lipocalin concentration: a baseline study for establishing reference ranges in preterm neonates
In brief
Urinary NGAL levels differ by gestational age, birth weight and sex
In 100 preterm infants born before 32 weeks and without acute kidney injury, urinary neutrophil gelatinase-associated lipocalin levels varied with gestational age, birth weight and sex during the first week after birth. The findings support developing tailored reference ranges, but this study did not establish cutoffs or test whether they improve kidney injury diagnosis.
- Journal
- Journal of perinatology : official journal of the California Perinatal Association (Q1)
- Published
- 7 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Nicole F Asdell, Jonathan L Slaughter, Shivam Joshi, Elizabeth M Bonachea, Tahagod Mohamed
- PMID
- 42844325
- DOI
- 10.1038/s41372-026-02848-x
Why clinicians should know about it
- Picked for Biochemistry (medical) (top studies of the week, 11 October 2026): Baseline uNGAL reference ranges for preterm neonates
Abstract
BACKGROUND: Acute kidney injury (AKI) affects up to 48% of extremely preterm neonates and is associated with significant morbidity and mortality. However, AKI diagnosis remains challenging in this population due to limitations of traditional markers like serum creatinine (Cr) and urine output. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has emerged as a promising biomarker for early AKI detection, but its clinical utility is hindered by a lack of normative reference ranges in preterm infants. OBJECTIVE: To characterize baseline uNGAL concentrations during the first postnatal week in preterm neonates without AKI and evaluate associations with gestational age (GA) at birth, birth weight (BW), and sex. METHODS: We conducted a cohort study of 100 neonates <32 weeks' gestation without AKI, necrotizing enterocolitis, sepsis, or urinary tract infection. uNGAL and uNGAL/uCr ratios were measured and analyzed by GA, birth weight, and sex. RESULTS: Baseline uNGAL concentrations vary significantly by gestational age at birth, birth weight, and sex in preterm neonates during the first postnatal week. CONCLUSIONS: Baseline uNGAL varies significantly with GA, BW, and sex in preterm neonates. These findings support the development of gestational age- and sex-specific normative reference ranges to improve the interpretation and diagnostic utility of uNGAL for neonatal AKI.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.