Page 87 - Abstract Book KONIKA 18

Nephrology

O-NEP-003
Association between Urine Protein/Creatinine Ratio and 24-Hour Urine Protein
(Esbach) in Children with Proteinuria

Herniati H. Alimadong, Syarifuddin Rauf, Dasril Daud
Department of Child Health, Faculty of Medicine Universitas Hasanuddin/Dr. Wahidin Sudirohusodo Hospital,
Makassar, South Sulawesi, Indonesia

Abstract
Background Urine protein measurement is one of the important markers used to assess the level of kidney
damage. Currently, many recent studies use the urine protein/creatinine ratio as a test for proteinuria. However,
the relationship between the ratio of urinary protein to creatinine and Esbach in children with proteinuria
has not been widely explained. Objective This study analyzed the relationship between the random urine
protein/creatinine ratio and Esbach in children with proteinuria. Methods The observational research method
with a cross sectional approach was taken at Wahidin Sudirohusodo Hospital and Unhas Makassar Hospital,
conducting from December 2019 to June 2020. The study sample was pediatric patients with proteinuria.
Patients who met the inclusion criteria were taken urine samples to check Esbach's levels and random urine
protein/creatinine ratio. The data were analyzed using SPSS. Results The sample was 55 patients, consisting
of 37 patients with mild proteinuria and 18 patients with severe proteinuria. The results showed the cut-off
value for the random urine protein/creatinine ratio in patients with severe and mild proteinuria was ≥3.56.
AUC 0.866, sensitivity 73%, specificity 72.2%, positive predictive value 56.5%, negative predictive value
84.4%. Conclusion The correlation between Esbach levels and the urine protein/creatinine ratio when obtained
is a moderate positive correlation, so it has a diagnostic value that if Esbach levels cannot be checked, the
urine protein/creatinine ratio can represent Esbach using the equation Y = 2.2131 + 0.04. (X).
Keywords: Esbach; random urine protein/creatinine ratio; proteinuria

O-NEP-004
A Deeper Look into Kidney Injury Biomarkers in Very Preterm Neonates:
Are They Comparable?

Henny A. Puspitasari, Diashati R. Mardiasmo, Retno Palupi-Baroto,
Eka L Hidayati, Rosalina D. Roeslani
Department of Child Health, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia
Abstract
Background Preterm neonates have oligonephronia and vulnerable to acute kidney injury (AKI) due to
perinatal hemodynamic alteration events. It is critical to detect structural kidney damages as early as possible.
Urine L-type fatty acid binding protein (u-LFABP) and urine neutrophil gelatinase-associated lipocalin
(u-NGAL) are proposed as excellent kidney injury biomarkers. Objective To compare u-LFABP and u-NGAL
as kidney injury diagnostic tests in very preterm neonates. Methods This retrospective study recruited 28
very preterm neonates admitted to neonatal intensive care unit (NICU), Dr. Cipto Mangunkusumo General
Hospital from November-December 2020. Baseline characteristics were recorded from electronic medical
records. u-LFABP was tested with POC kit, while u-NGAL was tested by ELISA method, both used stored
urine samples. Results Our study showed that at 72 hours, proportion of abnormal u-LFABP (83.3%) and
median abnormal u-NGAL of 173.5 (range 2.75-659.5) ng/mL were highest. Across time, u-LFABP profile
was comparable to u-NGAL at 72 hours. Using u-NGAL as standard examination, u-LFABP sensitivity and
specificity were 88.9% and 41.2% (0-48 hours), 92.9% and 30.0% (72 hours), and 80.0% and 40.0% (21
days). Older gestation age at 0-48 hours were associated with both normal u-LFABP levels (P=0.013) and
u-NGAL (P=0.005). Higher birth weight was associated with both normal u-LFABP (0-48 hours; P=0.022,
72 hours; P=0.013) and u-NGAL levels (0-48 hours; P=0.048). Conclusion The best time point for u-LFABP
and u-NGAL diagnostic test is at 72 hours of age.
Keywords: preterm; acute kidney injury; biomarker; urine L-type fatty acid binding protein; urine
neutrophil gelatinase-associated lipocalin

KONIKA XVIII Abstract Book 41