Early detection of acute kidney injury by serum cystatin C in critically ill children
Background We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr). Methods In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine cle...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2014, Vol.29 (1), p.133-138 |
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| creator | Ataei, Neamatollah Bazargani, Behnaz Ameli, Sonbol Madani, Abbas Javadilarijani, Faezeh Moghtaderi, Mastaneh Abbasi, Arash Shams, Sedigheh Ataei, Fatemeh |
| description | Background
We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr).
Methods
In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine clearance
(
eCCl
)
was calculated using a CysC-based glomerular filtration rate (GFR) equation from a serum Cr measured at the pediatric intensive care unit (PICU) entrance.
Results
The median age was 10 months (interquartile range, 3–36 months). Serum Cr, serum CysC, and eCCl (mean ± standard deviation [range]) were 0.5 ± 0.18 mg/dl (0.2–1.1 mg/dl), 0.53 ± 0.78 (0.01–3.7 mg/l), and 72.55 ± 28.72 (20.6–176.2) ml/min per 1.73 m
2
, respectively. The serum CysC level in patients with AKI was significantly higher than children with normal renal function (
p
|
| doi_str_mv | 10.1007/s00467-013-2586-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_journals_1461844825</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A354933397</galeid><sourcerecordid>A354933397</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-dc95300798c7c9444372da00feac121240181ce56434894f85fc63a68e66b6db3</originalsourceid><addsrcrecordid>eNp1kcFrHCEYxaW0NJu0f0AvRSj0Zqqj4-gxLGlTCPTSQG7iOt_sunWcVJ3D_Pdx2bRNYIsHwe_3nnzvIfSB0UtGafclUypkRyjjpGmVJO0rtGKCN4Rpdf8arajmjFDB7s_Qec57Sqmq2Ft01nCtNKdyhe6ubQoL7qGAK36KeBqwdXMB_Mv3ERbs435OC94sOEOaR-yWXGzxEa_rCLvki3c2VAsfAnY7H_oE8R16M9iQ4f3TfYHuvl7_XN-Q2x_fvq-vbolrqSqkd7rldRGtXOe0EIJ3TW8pHcA61rBGUKaYg1YKLpQWg2oHJ7mVCqTcyH7DL9Cno-9Dmn7PkIvZT3OK9UvDhGRKCNW0_6itDWB8HKaSrBt9duaKt0JzznVXKXKC2kKEZMMUYfD1-QV_eYKvp4fRu5OCz88EO7Ch7PIU5kPs-SXIjqBLU84JBvOQ_GjTYhg1h-LNsXhTizeH4s1hx49PScybEfq_ij9NV6A5ArmO4hbSs6j-6_oIx_K05g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1461844825</pqid></control><display><type>article</type><title>Early detection of acute kidney injury by serum cystatin C in critically ill children</title><source>MEDLINE</source><source>Springer Online Journals Complete</source><creator>Ataei, Neamatollah ; Bazargani, Behnaz ; Ameli, Sonbol ; Madani, Abbas ; Javadilarijani, Faezeh ; Moghtaderi, Mastaneh ; Abbasi, Arash ; Shams, Sedigheh ; Ataei, Fatemeh</creator><creatorcontrib>Ataei, Neamatollah ; Bazargani, Behnaz ; Ameli, Sonbol ; Madani, Abbas ; Javadilarijani, Faezeh ; Moghtaderi, Mastaneh ; Abbasi, Arash ; Shams, Sedigheh ; Ataei, Fatemeh</creatorcontrib><description>Background
We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr).
Methods
In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine clearance
(
eCCl
)
was calculated using a CysC-based glomerular filtration rate (GFR) equation from a serum Cr measured at the pediatric intensive care unit (PICU) entrance.
Results
The median age was 10 months (interquartile range, 3–36 months). Serum Cr, serum CysC, and eCCl (mean ± standard deviation [range]) were 0.5 ± 0.18 mg/dl (0.2–1.1 mg/dl), 0.53 ± 0.78 (0.01–3.7 mg/l), and 72.55 ± 28.72 (20.6–176.2) ml/min per 1.73 m
2
, respectively. The serum CysC level in patients with AKI was significantly higher than children with normal renal function (
p
< 0.001). The values for the cut-off point, sensitivity, specificity, and the area under curve (AUC) were determined for CysC as 0.6 mg/l, 73.9 %, 78.9 %, and 0.92 [95 % confidence interval (0.82–1)], respectively, and for Cr the values were 0.4 mg/dl, 68 %, 46.2 %, and 0.39, [95 % confidence interval (0.24–0.54)], respectively. The receiver operating characteristics (ROC) curve analysis revealed that CysC had a significantly higher diagnostic accuracy than eCCl (
p
< 0.001).
Conclusions
Our results identify that the sensitivity of serum CysC for detecting AKI is higher than that of serum Cr in a heterogeneous pediatric intensive care unit (PICU) population.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-013-2586-5</identifier><identifier>PMID: 23989306</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acute Kidney Injury - blood ; Acute Kidney Injury - diagnosis ; Acute renal failure ; Acute renal failure in children ; Area Under Curve ; Biomarkers - blood ; Care and treatment ; Child, Preschool ; Children ; Confidence intervals ; Creatine - blood ; Creatinine ; Critical Illness ; Critically ill ; Cystatin C - blood ; Diagnosis ; Disease ; Diseases ; Early Diagnosis ; Hospitals ; Humans ; Infant ; Intensive care ; Kidneys ; Medicine ; Medicine & Public Health ; Metabolism ; Nephrology ; Original Article ; Patient outcomes ; Pediatrics ; ROC Curve ; Urology</subject><ispartof>Pediatric nephrology (Berlin, West), 2014, Vol.29 (1), p.133-138</ispartof><rights>IPNA 2013</rights><rights>COPYRIGHT 2014 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-dc95300798c7c9444372da00feac121240181ce56434894f85fc63a68e66b6db3</citedby><cites>FETCH-LOGICAL-c508t-dc95300798c7c9444372da00feac121240181ce56434894f85fc63a68e66b6db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-013-2586-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-013-2586-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23989306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ataei, Neamatollah</creatorcontrib><creatorcontrib>Bazargani, Behnaz</creatorcontrib><creatorcontrib>Ameli, Sonbol</creatorcontrib><creatorcontrib>Madani, Abbas</creatorcontrib><creatorcontrib>Javadilarijani, Faezeh</creatorcontrib><creatorcontrib>Moghtaderi, Mastaneh</creatorcontrib><creatorcontrib>Abbasi, Arash</creatorcontrib><creatorcontrib>Shams, Sedigheh</creatorcontrib><creatorcontrib>Ataei, Fatemeh</creatorcontrib><title>Early detection of acute kidney injury by serum cystatin C in critically ill children</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background
We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr).
Methods
In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine clearance
(
eCCl
)
was calculated using a CysC-based glomerular filtration rate (GFR) equation from a serum Cr measured at the pediatric intensive care unit (PICU) entrance.
Results
The median age was 10 months (interquartile range, 3–36 months). Serum Cr, serum CysC, and eCCl (mean ± standard deviation [range]) were 0.5 ± 0.18 mg/dl (0.2–1.1 mg/dl), 0.53 ± 0.78 (0.01–3.7 mg/l), and 72.55 ± 28.72 (20.6–176.2) ml/min per 1.73 m
2
, respectively. The serum CysC level in patients with AKI was significantly higher than children with normal renal function (
p
< 0.001). The values for the cut-off point, sensitivity, specificity, and the area under curve (AUC) were determined for CysC as 0.6 mg/l, 73.9 %, 78.9 %, and 0.92 [95 % confidence interval (0.82–1)], respectively, and for Cr the values were 0.4 mg/dl, 68 %, 46.2 %, and 0.39, [95 % confidence interval (0.24–0.54)], respectively. The receiver operating characteristics (ROC) curve analysis revealed that CysC had a significantly higher diagnostic accuracy than eCCl (
p
< 0.001).
Conclusions
Our results identify that the sensitivity of serum CysC for detecting AKI is higher than that of serum Cr in a heterogeneous pediatric intensive care unit (PICU) population.</description><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - diagnosis</subject><subject>Acute renal failure</subject><subject>Acute renal failure in children</subject><subject>Area Under Curve</subject><subject>Biomarkers - blood</subject><subject>Care and treatment</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Confidence intervals</subject><subject>Creatine - blood</subject><subject>Creatinine</subject><subject>Critical Illness</subject><subject>Critically ill</subject><subject>Cystatin C - blood</subject><subject>Diagnosis</subject><subject>Disease</subject><subject>Diseases</subject><subject>Early Diagnosis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Intensive care</subject><subject>Kidneys</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolism</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Patient outcomes</subject><subject>Pediatrics</subject><subject>ROC Curve</subject><subject>Urology</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kcFrHCEYxaW0NJu0f0AvRSj0Zqqj4-gxLGlTCPTSQG7iOt_sunWcVJ3D_Pdx2bRNYIsHwe_3nnzvIfSB0UtGafclUypkRyjjpGmVJO0rtGKCN4Rpdf8arajmjFDB7s_Qec57Sqmq2Ft01nCtNKdyhe6ubQoL7qGAK36KeBqwdXMB_Mv3ERbs435OC94sOEOaR-yWXGzxEa_rCLvki3c2VAsfAnY7H_oE8R16M9iQ4f3TfYHuvl7_XN-Q2x_fvq-vbolrqSqkd7rldRGtXOe0EIJ3TW8pHcA61rBGUKaYg1YKLpQWg2oHJ7mVCqTcyH7DL9Cno-9Dmn7PkIvZT3OK9UvDhGRKCNW0_6itDWB8HKaSrBt9duaKt0JzznVXKXKC2kKEZMMUYfD1-QV_eYKvp4fRu5OCz88EO7Ch7PIU5kPs-SXIjqBLU84JBvOQ_GjTYhg1h-LNsXhTizeH4s1hx49PScybEfq_ij9NV6A5ArmO4hbSs6j-6_oIx_K05g</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Ataei, Neamatollah</creator><creator>Bazargani, Behnaz</creator><creator>Ameli, Sonbol</creator><creator>Madani, Abbas</creator><creator>Javadilarijani, Faezeh</creator><creator>Moghtaderi, Mastaneh</creator><creator>Abbasi, Arash</creator><creator>Shams, Sedigheh</creator><creator>Ataei, Fatemeh</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>2014</creationdate><title>Early detection of acute kidney injury by serum cystatin C in critically ill children</title><author>Ataei, Neamatollah ; Bazargani, Behnaz ; Ameli, Sonbol ; Madani, Abbas ; Javadilarijani, Faezeh ; Moghtaderi, Mastaneh ; Abbasi, Arash ; Shams, Sedigheh ; Ataei, Fatemeh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-dc95300798c7c9444372da00feac121240181ce56434894f85fc63a68e66b6db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Kidney Injury - blood</topic><topic>Acute Kidney Injury - diagnosis</topic><topic>Acute renal failure</topic><topic>Acute renal failure in children</topic><topic>Area Under Curve</topic><topic>Biomarkers - blood</topic><topic>Care and treatment</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Confidence intervals</topic><topic>Creatine - blood</topic><topic>Creatinine</topic><topic>Critical Illness</topic><topic>Critically ill</topic><topic>Cystatin C - blood</topic><topic>Diagnosis</topic><topic>Disease</topic><topic>Diseases</topic><topic>Early Diagnosis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Intensive care</topic><topic>Kidneys</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolism</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Patient outcomes</topic><topic>Pediatrics</topic><topic>ROC Curve</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ataei, Neamatollah</creatorcontrib><creatorcontrib>Bazargani, Behnaz</creatorcontrib><creatorcontrib>Ameli, Sonbol</creatorcontrib><creatorcontrib>Madani, Abbas</creatorcontrib><creatorcontrib>Javadilarijani, Faezeh</creatorcontrib><creatorcontrib>Moghtaderi, Mastaneh</creatorcontrib><creatorcontrib>Abbasi, Arash</creatorcontrib><creatorcontrib>Shams, Sedigheh</creatorcontrib><creatorcontrib>Ataei, Fatemeh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ataei, Neamatollah</au><au>Bazargani, Behnaz</au><au>Ameli, Sonbol</au><au>Madani, Abbas</au><au>Javadilarijani, Faezeh</au><au>Moghtaderi, Mastaneh</au><au>Abbasi, Arash</au><au>Shams, Sedigheh</au><au>Ataei, Fatemeh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early detection of acute kidney injury by serum cystatin C in critically ill children</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2014</date><risdate>2014</risdate><volume>29</volume><issue>1</issue><spage>133</spage><epage>138</epage><pages>133-138</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background
We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr).
Methods
In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine clearance
(
eCCl
)
was calculated using a CysC-based glomerular filtration rate (GFR) equation from a serum Cr measured at the pediatric intensive care unit (PICU) entrance.
Results
The median age was 10 months (interquartile range, 3–36 months). Serum Cr, serum CysC, and eCCl (mean ± standard deviation [range]) were 0.5 ± 0.18 mg/dl (0.2–1.1 mg/dl), 0.53 ± 0.78 (0.01–3.7 mg/l), and 72.55 ± 28.72 (20.6–176.2) ml/min per 1.73 m
2
, respectively. The serum CysC level in patients with AKI was significantly higher than children with normal renal function (
p
< 0.001). The values for the cut-off point, sensitivity, specificity, and the area under curve (AUC) were determined for CysC as 0.6 mg/l, 73.9 %, 78.9 %, and 0.92 [95 % confidence interval (0.82–1)], respectively, and for Cr the values were 0.4 mg/dl, 68 %, 46.2 %, and 0.39, [95 % confidence interval (0.24–0.54)], respectively. The receiver operating characteristics (ROC) curve analysis revealed that CysC had a significantly higher diagnostic accuracy than eCCl (
p
< 0.001).
Conclusions
Our results identify that the sensitivity of serum CysC for detecting AKI is higher than that of serum Cr in a heterogeneous pediatric intensive care unit (PICU) population.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23989306</pmid><doi>10.1007/s00467-013-2586-5</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2014, Vol.29 (1), p.133-138 |
| issn | 0931-041X 1432-198X |
| language | eng |
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| source | MEDLINE; Springer Online Journals Complete |
| subjects | Acute Kidney Injury - blood Acute Kidney Injury - diagnosis Acute renal failure Acute renal failure in children Area Under Curve Biomarkers - blood Care and treatment Child, Preschool Children Confidence intervals Creatine - blood Creatinine Critical Illness Critically ill Cystatin C - blood Diagnosis Disease Diseases Early Diagnosis Hospitals Humans Infant Intensive care Kidneys Medicine Medicine & Public Health Metabolism Nephrology Original Article Patient outcomes Pediatrics ROC Curve Urology |
| title | Early detection of acute kidney injury by serum cystatin C in critically ill children |
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