ESPN 51th Annual Meeting

ESPN 2018


 
The tubular damage markers: neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in newborns born after diabetes in pregnancy
MONIKA KAMIANOWSKA 1 MAREK SZCZEPAńSKI 1 ELżBIETA KULIKOWSKA 1 BARBARA BEBKO 1 ANNA WASILEWSKA 2

1- DEPARTMENT OF NEONATOLOGY AND NEONATAL INTENSIVE CARE, MEDICAL UNIVERSITY OF BIALYSTOK, POLAND
2- DEPARTMENT OF PEDIATRICS AND NEPHROLOGY, MEDICAL UNIVERSITY OF BIALYSTOK, POLAND
 
Introduction:

Diabetes mellitus is a common complication in pregnancy. Diabetes affects adversely both a mother and a child, causes early perinatal complications and the long-term consequences. Regarding the fact that, diabetes has been found to be the cause of chronic kidney disease, and end-stage renal disease we wanted to investigate whether maternal diabetes can affect kidney function in newborn. Neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule - 1 (KIM-1) are very sensitive biomarker of early stage of renal injury. 

Material and methods:

 The study included 138 full-term newborns. Fifty newborns, who were the result of pregnancies complicated by diabetes mellitus (type 1 diabetes, gestational diabetes requiring insulin therapy or diet therapy) and 88 healthy newborns. The concentration of NGAL and KIM-1 was determined in urine with a commercially available ELISA kit (ng/ml) and were calculated for 1 mg of creatinine (NGAL/cr. and KIM-1/cr. respectively), shown as the median (Q1-Q3).

Results:

 We found significantly higher urine concentration of NGAL (25.7 (11.8-40.8))  and NGAL/cr. (29.1 (19.1-47.4)) in babies from diabetic pregnancies when compared to reference group (16.74 (9.9-27.5)) and (21.9 (14.6-29.8)) (p=0.01, p<0.01) respectively. When we assessed only subgroup on insulin therapy we found significantly higher urine concentration of NGAL (27.8 (13.6- 44.2)), NGAL/cr. (31.9 (17.6 - 57.4)) and KIM/ cr. (2.6 (1.6 - 5.5))  when compared to reference group (16.7 (9.9-27.5)), (21.9 (14.6-29.8)), (1.9 (0.8-3.2))  (p=0.01, p=0.02, p= 0.02) respectively. 

Conclusions:

 To the best of our knowledge in this study, we have been the first showing that maternal diabetes mellitus during pregnancy may causes tubular kidney damage in newborns.