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01-01-2014 | Original Article

Early detection of acute kidney injury by serum cystatin C in critically ill children

Authors: Neamatollah Ataei, Behnaz Bazargani, Sonbol Ameli, Abbas Madani, Faezeh Javadilarijani, Mastaneh Moghtaderi, Arash Abbasi, Sedigheh Shams, Fatemeh Ataei

Published in: Pediatric Nephrology | Issue 1/2014

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 m², 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.

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Title: Early detection of acute kidney injury by serum cystatin C in critically ill children
Authors: Neamatollah Ataei
Behnaz Bazargani
Sonbol Ameli
Abbas Madani
Faezeh Javadilarijani
Mastaneh Moghtaderi
Arash Abbasi
Sedigheh Shams
Fatemeh Ataei
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 1/2014
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-013-2586-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early detection of acute kidney injury by serum cystatin C in critically ill children

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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