Discovery urinary metabolomics of preterm neonatal acute kidney injury

BACKGROUND: Diagnosing acute kidney injury (AKI) in preterm neonates remains difficult, and its underlying causes are not well understood. This study aimed to compare urinary metabolite profiles in preterm neonates with and without AKI. METHODS: We conducted a prospective observational study of neonates born at 1) and with significant differences between metabolites within biochemical pathways including branch chain fatty acid oxidation, tyrosine metabolism, and carnitine synthesis. Longitudinal analysis also revealed metabolite changes preceding AKI onset, with distinct profiles compared to neonates who did not develop AKI. CONCLUSIONS: Preterm neonates with AKI exhibit distinct urinary metabolomic profiles compared to those without AKI. These findings suggest potential for metabolomic signatures to aid in early AKI detection, phenotype classification, and identification of therapeutic targets. Further research is needed to refine compound identification and timing of metabolite changes.