The tubular damage markers: neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in newborns with exposure to maternal diabetes during pregnancy

Abstract

Introduction Chronic kidney disease and end-stage renal disease have been found to be caused by diabetes. More recently, the renal tubulointerstitium has been increasingly assumed to play a role in the pathogenesis of diabetic nephropathy with prolonged exposure to a variety of metabolic and haemodynamic injuring factors associated with sustained hyperglycaemia as contributing factors. This study aimed to investigate whether maternal diabetes could be the factor affecting kidney function in a newborn with the use of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) – biomarkers of renal injury. Material and methods The study included 138 full-term newborns: 50 newborns from diabetic pregnancies and 88 healthy newborns. The concentrations of NGAL and KIM-1 were determined in urine in the first or the second day of life with a commercially available ELISA kit. Results Considerably higher urine level of NGAL (25.7 (11.8–40.8)) and NGAL/cr. (29.1 (19.1–47.4)) in babies from diabetic pregnancies has been found when compared to the reference group (16.74 (9.9–27.5)) and (21.9 (14.6–29.8)) (p = 0.01, p < 0.01) respectively. We also found a significantly higher urine level of NGAL (27.8 (13.6–44.2)), NGAL/cr. (31.9 (17.6–57.4)), and KIM-1/cr. (2.6 (1.6–5.5)) in babies of diabetic mothers treated with insulin when compared to the 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 Based on the results of this study, we indicate for the first time that maternal diabetes mellitus during pregnancy may be considered as the cause of tubular kidney damage in newborns.

Keywords

• diabetes mellitus
• kidney injury
• biomarkers