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

2013 ◽  
Vol 29 (1) ◽  
pp. 133-138 ◽  
Author(s):  
Neamatollah Ataei ◽  
Behnaz Bazargani ◽  
Sonbol Ameli ◽  
Abbas Madani ◽  
Faezeh Javadilarijani ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Detection ◽  
Critically Ill ◽  
Cystatin C ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum Cystatin C ◽  
Serum Cystatin

scholarly journals Serum cystatin C is a poor biomarker for diagnosing acute kidney injury in critically-ill children

2013 ◽  
Vol 17 (2) ◽  
pp. 92-98 ◽  
Author(s):  
Hanan M. Hamed ◽  
Seham Awad El-Sherbini ◽  
Nahla A. Barakat ◽  
Tarek M. Farid ◽  
Enas Abdel Rasheed
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Cystatin C ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum Cystatin C ◽  
Serum Cystatin

scholarly journals Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Christopher J. Kirwan ◽  
Barbara J. Philips ◽  
Iain A. M. MacPhee
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin

Introduction.RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI), but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR) can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI.Aim.This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl) in critically ill patients with AKI.Methods.Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl.Results.eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD).Conclusions.eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

scholarly journals Role of Serum Cystatin C in Early Diagnosis of Acute Kidney Injury in Neonates with Bronchopulmonary Dysplasia

2021 ◽  
pp. 38-48
Author(s):  
Sara Mohamed Elashry ◽  
Maher Ahmed Abdelhafez ◽  
Mostafa Mohamed Awny ◽  
Nahed Mohamed Elwan ◽  
Hamed Mohamed Elsharkawy
Keyword(s):  
Acute Kidney Injury ◽  
Early Detection ◽  
Early Diagnosis ◽  
Serum Creatinine ◽  
Bronchopulmonary Dysplasia ◽  
Cystatin C ◽  
Resistive Index ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin

Background: The neonate is more susceptible to acute kidney injury (AKI) than others due to functional and developmental immaturity, hemodynamic changes that occur at birth, and possibility of hypovolemia due to increased insensible water losses. The aim of this work was early detection of the occurrence of AKI through measurement of serum cystatin C (CysC) and assessment of renal function in patients with bronchopulmonary dysplasia (BPD) in order to initiate early and appropriate therapeutic measures as indicated. Methods: This prospective observational study was carried out on 50 neonates diagnosed as cases of BPD with gestational age ranging from 28w to 38w. Urea, creatinine and serum CysC were measured twice, the first measurement was at the time of diagnosis of BPD and the second one was 3 days later with estimation of creatinine based Glomerular filtration rate (GFR) and cystatin based GFR.renal Doppler ultrasound was performed to measure peak systolivc velocity, end diastolic velocity and resistive index. Results: There were 7 cases with abnormal GFR According to the first creatinine based GFR. There were 16 cases with abnormal GFR according to the first cystatin C based GFR with no statistically significance difference between both measurements. 5 patients were classified to have AKI based on serum creatinine level. There was statistically significant increase in 1st, 2nd serum creatinine, 1st and 2nd serum cystatin C levels in the AKI patients in comparison to non AKI group. On the other hand, there was statistically significant decrease in 1st, 2nd creatinine based GFR, 1st and 2nd cystatin C based GFR. There was statistically significant increase in mortality in the AKI patients if compared to non AKI patient. There was statistically significant increase in SBP, DPB and PCO2 in the AKI patients in comparison to non AKI group. Conclusions: Measurement of serum CysC and estimation of cystatin based GFR can help in early detection of cases with renal malfunction among the patients with BPD before rise of serum creatinine Early diagnosis will lead to improvement of the outcome and shortening of the hospital stay.

scholarly journals Acute Kidney Injuries in Children with Severe Malaria

2020 ◽  
Vol 20 (4) ◽  
pp. e312-317
Author(s):  
Folake M. Afolayan ◽  
Olanrewaju T. Adedoyin ◽  
Mohammed B. Abdulkadir ◽  
Olayinka R. Ibrahim ◽  
Sikiru A. Biliaminu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Severe Malaria ◽  
Diagnostic Criteria ◽  
Cystatin C ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria.

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