SWEET PEE Study

Kidney development and function in the extremely premature infant differs from that of older infants, children, and adults. While we know these differences exist, there have been limited studies evaluating urine glucose (sugar) thresholds and urine markers of acute kidney injury (AKI) in the extremely premature population.

Neonatal hyperglycemia (high glucose levels) can lead to dehydration in infants via multiple mechanisms. Both hyperglycemia and dehydration are associated with increased morbidity and mortality in extremely preterm infants. The renal glucose threshold defined as the plasma glucose level above which the filtered glucose escapes kidney reabsorption and is present in the urine, has been well studied in older children and adults, but previously mentioned there is limited data in the extremely premature population. Therefore, this information could be important in guiding management for fluid balance and glucose infusion rates in these preterm infants.

Additionally, data have shown that urinary biomarkers such as neutrophil gelatinase associated lipocalin (NGAL) and epidermal growth factor (EGF)  are useful early predictors of AKI in the preterm population which is traditionally diagnosed with serum creatinine. However, there is limited data in infants born at < 25 weeks gestational age, especially when determining their usefulness in predicting AKI. There is a need to further evaluate the potential role that urinary biomarkers of kidney function and injury can have in the diagnosis of AKI in the extremely preterm population.

In this study, urine will be collected from cotton balls placed in the diaper of extremely premature infants < 28 weeks gestational age at several time points for the first 7 days after birth. The infant’s care will not be affected. From the collected urine we will measure glucose levels on all urine samples. A subset of patients < 25 weeks GA  will also have urinary NGAL and EGF measured. All included infants will be followed until discharge from the hospital to monitor hospital course and outcomes at the time of discharge.

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Purpose & Aim

Population of the study: Extremely preterm infants < 28 weeks’ gestation born at Children’s Memorial Hermann Hospital
Measurements: Measures of urine glucose and markers of kidney function and injury
Outcome: Comparison of measured markers in all study subjects and their usefulness in determining AKI, fluid balance, glucose needs

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Trial Information

Target Recruitment: 120
Funder: Internal
Duration of Study: April 2023 – April 2024

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Study Principal Investigators

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Links

Protocol
Provider Handout Sheet
Parent Information Sheet: English | Spanish