Serum cystatin C for acute kidney injury evaluation in children treated with aminoglycosides

Autor: Lorraine Lau, Michael Zappitelli, Michael Pizzi, Zubaida Al-Ismaili, Theresa Mottes, Stuart L. Goldstein, Jillian Caldwell, Maya Harel-Sterling, Michael R. Bennett, Prasad Devarajan, Larry C. Lands, Melissa Piccioni
Rok vydání: 2016
Předmět:
Male
Nephrology
medicine.medical_specialty
Pathology
Adolescent
030232 urology & nephrology
Renal function
Pilot Projects
urologic and male genital diseases
behavioral disciplines and activities
Gastroenterology
Article
Cohort Studies
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Predictive Value of Tests
Internal medicine
medicine
Humans
Prospective Studies
Cystatin C
Child
Prospective cohort study
Creatinine
urogenital system
business.industry
Incidence
Area under the curve
Acute kidney injury
030208 emergency & critical care medicine
Bacterial Infections
Acute Kidney Injury
medicine.disease
female genital diseases and pregnancy complications
Anti-Bacterial Agents
Aminoglycosides
Treatment Outcome
chemistry
Area Under Curve
Child
Preschool
Pediatrics
Perinatology and Child Health
Biomarker (medicine)
Female
business
Biomarkers
Kidney disease
Zdroj: Pediatric Nephrology. 32:163-171
ISSN: 1432-198X
0931-041X
DOI: 10.1007/s00467-016-3450-1
Popis: Serum cystatin C (CysC) is a more accurate glomerular filtration rate marker than serum creatinine (SCr) and may rise more quickly with acute kidney injury (AKI). We performed a prospective cohort study of 81 non-critically ill children during 110 aminoglycoside (AG) treatments. We calculated area under the curve (AUC) for CysC to diagnose SCr-defined AKI and predict persistent AKI. SCr-AKI definition was based on the Kidney Disease: Improving Global Outcomes (≥stage 1: ≥50 % or 26.5 μmol/l SCr rise from baseline; stage 2: SCr doubling); CysC-AKI was based on a modified version using CysC rise. SCr-AKI and CysC-AKI developed in 45 and 48 % treatments, respectively. CysC rise predicted stage 1 (AUC = 0.75, 95 % CI 0.60–0.90) and 2 (AUC = 0.85, 95 % CI 0.75–0.95) SCr-AKI 2 days before SCr-AKI attainment. The best combined sensitivity/specificity for percent CysC rise to predict stage 1 SCr-AKI was with a 44 % CysC rise (sensitivity = 65 %, specificity = 83 %). CysC rise on day of SCr-AKI development was associated with SCr-AKI ≥48 h (AUC = 0.73, 95 % CI 0.56–0.90) and ≥50 % persistent SCr rise at treatment end (AUC = 0.76, 95 % CI 0.61–0.90). CysC is as an early AKI biomarker and predictive of persistent AKI on aminoglycoside treatment.
Databáze: OpenAIRE
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