Urinary NGAL and Hematic ADMA Levels: An Early Sign of Cardio-Renal Syndrome in Young Adults Born Preterm?

J Matern Fetal Neonatal Med. 2013 Oct;26 Suppl 2:80-3. doi: 10.3109/14767058.2013.829698.


Background: Prematurity at birth is a known risk factor for the development of an early chronic renal disease. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a well established biomarker of kidney injury, while high blood levels of asymmetric dimethylarginine (ADMA) are associated with the future development of adverse cardiovascular events and cardiac death.

Aims: (1) to verify the presence of statistically significant differences between urinary NGAL and hematic ADMA levels in young adults born preterm at extremely low birth weight (<1000 g; ex-ELBW) and those of a control group of healthy adults born at term (C) (2) to seek correlations between NGAL and ADMA levels, which would indicate the presence of an early cardio-renal involvement in ex-ELBW.

Methods: Twelve ex-ELBW subjects (six males and six female, mean age: 23.9 ± 3.2 years) were compared with 12 C (six males and six female). Urinary NGAL and hematic ADMA levels were assessed.

Results: Urinary NGAL levels were higher in ex- ELBW subjects compared to C (p < 0.05), as well as hematic ADMA concentrations (p < 0.05). A statistically significant correlation was found between urinary NGAL and ADMA (r = -0.60, p < 0.04).

Conclusions: Our preliminary findings support the hypothesis that in ex-ELBW subjects the development of an early chronic kidney disease contributes towards inducing an increase in the atherosclerotic process and in the risk of future adverse cardiovascular events.

MeSH terms

  • Acute-Phase Proteins / urine*
  • Adolescent
  • Adult
  • Adult Children*
  • Arginine / analogs & derivatives*
  • Arginine / blood
  • Cardio-Renal Syndrome / blood
  • Cardio-Renal Syndrome / diagnosis*
  • Cardio-Renal Syndrome / urine
  • Case-Control Studies
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Lipocalin-2
  • Lipocalins / urine*
  • Male
  • Pregnancy
  • Premature Birth
  • Prognosis
  • Proto-Oncogene Proteins / urine*
  • Young Adult


  • Acute-Phase Proteins
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins
  • N,N-dimethylarginine
  • Arginine