Predictive ability of urinary biomarkers for outcome in children with acute kidney injury

Autor: Franz Schaefer, Rabindra N. Mishra, Pradeep Srivastava, Om Prakash Mishra, Abhishek Abhinay, Rajniti Prasad, Avinash K. Rai, Khushaboo Pandey
Rok vydání: 2016
Předmět:
Male
Nephrology
medicine.medical_specialty
Adolescent
Urinary system
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
Lipocalin
urologic and male genital diseases
03 medical and health sciences
0302 clinical medicine
Lipocalin-2
Predictive Value of Tests
Internal medicine
Acetylglucosaminidase
Humans
Medicine
Prospective Studies
Threshold Limit Values
Child
Intensive care medicine
Dialysis
urogenital system
business.industry
Interleukin-18
Acute kidney injury
Infant
Acute Kidney Injury
Length of Stay
Urinary biomarkers
medicine.disease
Survival Analysis
Cross-Sectional Studies
Child
Preschool
Pediatrics
Perinatology and Child Health
Disease Progression
Etiology
Kidney Failure
Chronic
Female
Interleukin 18
business
Peritoneal Dialysis
Biomarkers
Zdroj: Pediatric Nephrology. 32:521-527
ISSN: 1432-198X
0931-041X
Popis: Urinary neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-D-glucosaminidase (NAG), and interleukin 18 (IL-18) were found to be useful for early detection of acute kidney injury (AKI). The objective of this study was to determine the predictive ability of biomarkers for mortality and variation in levels in relation to different stages of AKI, need for dialysis, etiologies, and with duration of hospital stay.Urinary NGAL, NAG, and IL-18 levels were measured in 50 children with AKI and 30 age- and gender-matched healthy controls. AKI was classified as per pediatric Risk, Injury, Failure, Loss, and End-stage (RIFLE) criteria.Median NGAL, NAG, and IL-18 values were significantly increased in AKI patients compared with controls (p 0.001), with significant increase among risk, injury, and failure stages. Nonsurvivors had significantly higher median levels of NGAL (p = 0.008) and NAG (p = 0.018) than survivors. NGAL had highest area under the curve (AUC) at 0.750 [confidence interval (CI) 0.580-0.920], followed by NAG at 0.724 (CI 0.541-0.907), with sensitivity and specificity of 75 % each; and IL-18 (AUC 0.688, CI 0.511-0.864), with sensitivity 62.5 % and specificity 70.8 %, for predicting mortality. Values were significantly higher in patients who required peritoneal dialysis (PD) than in those in whom it was not indicated. Levels were comparable among different etiologies. Only NGAL level was found to be a significant risk factor associated with longer duration of hospital stay.Urinary NGAL and NAG had modest predictive ability for mortality. Children requiring dialysis had significantly raised levels, and the NGAL level had significant association with duration of hospital stay.
Databáze: OpenAIRE
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