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Published in: Pediatric Nephrology 2/2011

01-02-2011 | Original Article

Urinary biomarkers to detect acute kidney injury in the pediatric emergency center

Authors: Yue Du, Michael Zappitelli, Asad Mian, Michael Bennett, Qing Ma, Prasad Devarajan, Ravindra Mehta, Stuart L. Goldstein

Published in: Pediatric Nephrology | Issue 2/2011

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Abstract

We conducted a prospective study in pediatric patients presenting to an emergency center (EC) to (1) test the ability of urinary acute kidney injury (AKI) biomarkers to predict AKI presence and severity and (2) determine if these biomarkers offer similar precision in patients with versus without a known baseline SCr. The accuracy of five putative urinary biomarkers to detect AKI presence and severity was evaluated in 252 children presenting to our EC. AKI was defined by the modified pediatric RIFLE (pRIFLE) system. Eighteen children had AKI by pRIFLE, yet 33–50% of these AKI cases may have been missed since the EC SCr was <1 mg/dl. Urinary NGAL, Kidney Injury Molecule-1 (KIM-1) and beta-2 microglobulin (β2M) all demonstrated good to very good accuracy (AUC > 0.70 to 0.80) to predict patients with pRIFLE-Injury (>50% decrease in eCCl) versus patients with pRIFLE-Risk (25–50% decrease in eCCl) or without AKI. Our data suggest urinary biomarkers may serve well to detect AKI accurately in the pediatric EC setting, even in cases where SCr levels are normal. Further study is required to determine if these biomarkers obtained in the EC can predict AKI development or progression in hospitalized patients.
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Metadata
Title
Urinary biomarkers to detect acute kidney injury in the pediatric emergency center
Authors
Yue Du
Michael Zappitelli
Asad Mian
Michael Bennett
Qing Ma
Prasad Devarajan
Ravindra Mehta
Stuart L. Goldstein
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Pediatric Nephrology / Issue 2/2011
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-010-1673-0

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