Proenkephalin as a new biomarker for pediatric acute kidney injury - reference values and performance in children under one year of age
| Autor: | Joost van Rosmalen, Nadies E C van de Water, Michiel F. Schreuder, Dick Tibboel, Saskia N. de Wildt, Stan J. F. Hartman, Oliver Hartmann, Joachim Struck, Janin Schulte, Remi Beunders, Peter Pickkers, Alexandra J M Zwiers |
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| Přispěvatelé: | Anesthesiology, Epidemiology, Pediatric Surgery |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Clinical Biochemistry lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] 030232 urology & nephrology 030204 cardiovascular system & hematology Young infants Cohort Studies 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine Reference Values Internal medicine Humans Medicine Protein Precursors Immunoassay biology business.industry Proenkephalin-A Biochemistry (medical) Infant Newborn Acute kidney injury Infant Enkephalins General Medicine Acute Kidney Injury medicine.disease Peptide Fragments Proenkephalin Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ROC Curve Cystatin C Area Under Curve Reference values biology.protein Biomarker (medicine) Female Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] business Biomarkers Cohort study |
| Zdroj: | Clinical Chemistry and Laboratory Medicine, 58(11), 1911-1919. De Gruyter Clinical Chemistry and Laboratory Medicine, 58, 11, pp. 1911-1919 Clinical Chemistry and Laboratory Medicine, 58, 1911-1919 |
| ISSN: | 1434-6621 |
| DOI: | 10.1515/cclm-2020-0381 |
| Popis: | Objectives Acute kidney injury (AKI) is common in critically ill children, but current biomarkers are suboptimal. Proenkephalin A 119–159 (PENK) is a promising new biomarker for AKI in adults, but pediatric data is lacking. We determined PENK reference intervals for healthy children, crucial for clinical implementation, and explored concentrations in critically ill infants aged under 1 year. Methods Observational cohort study in healthy infants and critically ill children aged 0–1 years. Reference values were determined using generalized additive models. Plasma PENK concentrations between healthy children and critically ill children with and without AKI, were compared using linear mixed modelling. The performance of PENK as AKI biomarker was compared to cystatin C (CysC) and β-trace protein (BTP) using receiver-operating-characteristic (ROC) analysis. Results PENK concentrations in 100 healthy infants were stable during the first year of life (median 517.3 pmol/L). Median PENK concentrations in 91 critically ill children, were significantly higher in those with AKI (n=40) (KDIGO Stage 1 507.9 pmol/L, Stage 2 704.0 pmol/L, Stage 3 930.5 pmol/L) than non-AKI patients (n=51, 432.2 pmol/L) (p Conclusions PENK reference values are much higher in young infants than adults, but clearly discriminate between children with and without AKI, with comparable or better performance than CysC and BTP. Our results illustrate the importance of establishing age-normalized reference values and indicate PENK as a promising pediatric AKI biomarker. |
| Databáze: | OpenAIRE |
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