Early detection of microalbuminuria and hypertension in children of very low birthweight

Abstract

Objective. We retrospectively investigated a cohort of very low birthweight infants (VLBWI) by comparing two methods for assessment of albuminuria: nephelometry (standard) and high performance liquid chromatography (HPLC), measuring urinary immunoreactive and non-immunoreactive albumin to evaluate if the latter is more sensitive in identifying childhood onset of albuminuria and hypertension in VLBWI individuals.

Methods. Spot urine samples of a total of 109 subjects (5.3 ± 2.2 years old) who were VLBWI were investigated by HPLC and nephelometry. Twenty-eight subjects were small for gestational age (SGA) and 81 were appropriate for gestational age (AGA). Blood Pressure (BP) was also recorded.

Results. Twelve children (11%) with albuminuria 20 mg/g Cr by nephelometry versus 48 (44.5%) by HPLC (p < 0.001) were identified. The mean ± SD of values in the range of normoalbuminuria was 2.9 ± 5.81 by nephelometry versus 22.6 ± 14 for HPLC (p < 0.001). The values were not statistically different in the two birthweight categories (<1000, 1000–1499 g), in AGA versus SGA and in high BP (>90th percentile) versus normal BP children.

Conclusions. Microalbuminuria by HPLC was more marked in VLBWI than in adults and the difference between values using the two methods was significative.

Keywords:

• Microalbuminuria
• urinary biomarkers
• hypertension in children
• very low birthweight
• newborns

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Erratum