Urinary NGAL and hematic ADMA levels: an early sign of cardio-renal syndrome in young adults born preterm?

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.