Relationship Between Body Weight Serum Creatinine, Cystatin C in Early Prediction of Acute Kidney Injury in Critically Ill Neonates.

Acute kidney injury (AKI) is a common and strong problem in the diagnosis of which based on measurement of BUN and serum creatinine. These traditional methods are not sensitive and specific for the diagnosis of AKI. AKI is associated with increased morbidity and mortality in critically ill patients and a quick detection is impossible with BUN and serum creatinine. A number of serum and urinary proteins have been identified that may messenger AKI prior to a rise in BUN and serum creatinine. New biomarkers of AKI, including NGAL, KIM-1, cystatin-C, IL-18, and L-FABP, are more favourable tests than creatinine which have been identified and studied in several experimental and clinical training. This paper will discuss some of these new biomarkers and their potential as useful signs of AKI. We searched the literature using PubMed and MEDLINE with acute kidney injury, urine, and serum new biomarkers and the articles were selected only from publication types in English.

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Cystatin C- an early marker indicative of renal dysfunction in critically ill children: a prospective cohort study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193709 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1981

Author(s):

Hawwa M.S. Siddiqua ◽

Mathew John ◽

V. C. Manoj ◽

Rati Santhakumar

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Serum Creatinine ◽

Renal Dysfunction ◽

Critically Ill ◽

Cystatin C ◽

Prospective Cohort ◽

Kidney Injury ◽

Critically Ill Children ◽

Serum And Urine

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.

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Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates

Journal of Pediatric Urology ◽

10.1016/j.jpurol.2019.12.001 ◽

2020 ◽

Vol 16 (2) ◽

pp. 206.e1-206.e8

Author(s):

Akram E. El-sadek ◽

Mohamed A. El-Gamasy ◽

Eman G. Behiry ◽

Ahmed A. Torky ◽

Mohamed A. Fathy

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Cystatin C ◽

Resistive Index ◽

Kidney Injury ◽

Renal Resistive Index ◽

Early Predictors ◽

Critically Ill Neonates

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Urine interleukin-18 and cystatin-C as biomarkers of acute kidney injury in critically ill neonates

Pediatric Nephrology ◽

10.1007/s00467-011-2072-x ◽

2012 ◽

Vol 27 (5) ◽

pp. 851-860 ◽

Cited By ~ 32

Author(s):

Yanhong Li ◽

Chenlu Fu ◽

Xiaofei Zhou ◽

Zhihui Xiao ◽

Xueming Zhu ◽

...

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Cystatin C ◽

Kidney Injury ◽

Interleukin 18 ◽

Critically Ill Neonates

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GW28-e0340 A novel simple experimental model for low-osmolar contrast-induced acute kidney injury using different definitions based on the levels of serum creatinine and cystatin C

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.07.025 ◽

2017 ◽

Vol 70 (16) ◽

pp. C7

Author(s):

Yuanhui Liu ◽

Ning Tan ◽

Yong Liu ◽

Jiyan Chen

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Experimental Model ◽

Cystatin C ◽

Kidney Injury

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Urinary Nephrin as a Biomarker of Glomerular Maturation and Injury Is Associated with Acute Kidney Injury and Mortality in Critically Ill Neonates

Neonatology ◽

10.1159/000499083 ◽

2019 ◽

Vol 116 (1) ◽

pp. 58-66

Author(s):

Jiao Chen ◽

Gen Li ◽

Sanfeng Wang ◽

Xiaohan Hu ◽

Yunqing Sun ◽

...

Keyword(s):

Acute Kidney Injury ◽

Critically Ill ◽

Kidney Injury ◽

Critically Ill Neonates

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138 Fluid overload in newborns undergoing abdominal surgery

Paediatrics & Child Health ◽

10.1093/pch/pxab061.109 ◽

2021 ◽

Vol 26 (Supplement_1) ◽

pp. e96-e97

Author(s):

Nikoo Niknafs

Keyword(s):

Acute Kidney Injury ◽

Body Weight ◽

Weight Gain ◽

Abdominal Surgery ◽

Serum Creatinine ◽

Fluid Intake ◽

Fluid Overload ◽

Kidney Injury ◽

Ventilator Support ◽

Post Operation

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Infants undergoing abdominal surgery, particularly those born preterm, are at risk of postoperative fluid overload and acute kidney injury due to immature cardiac and renal functions, which could contribute to increased morbidity and mortality. Objectives The purpose of this study was to evaluate the burden of fluid overload and acute kidney injury among newborns undergoing abdominal surgery and the association with adverse neonatal outcomes. Design/Methods Newborns who had undergone laparotomy from January 2017 to June 2019 admitted to a tertiary level Neonatal Intensive Care Unit were included in this retrospective cohort study. Fluid overload was assessed by the maximum percentage change in body weight and the difference between actual and prescribed fluid intake post-operatively. Acute kidney injury was defined as an increase in serum creatinine >1.5 times of baseline or >26 mmol/L, or oliguria (< 0 .5mL/kg/hr over 24-hour). Results There were 60 eligible infants with medians [IQR] gestational age (GA) and birth weight being 29 weeks [25–36] and 1240 grams [721–2871], respectively. Indications for laparotomy included small bowel obstruction (45%), necrotizing enterocolitis (23%), and large bowel obstruction (11.7%). In the first three post-operative days, 24/60 (40%) required inotropes, 5/59 (8.5%) had hyponatremia (<130 mmol/L), and 15/31(48.4%) developed hypoalbuminemia (<20 g/L). 52/60 (86.7%) infants had serum creatinine measured and 4 (6.7%) fulfilled our AKI criteria. The median of actual fluid intake was significantly higher than the prescribed fluid intake in the first 7 post-operative days (p<0.01) [Figure 1]. Medians [IQR] of maximum % change of body weight within the first 3- and 7-days post operation were 6 [3–13] and 11 [5 –17], respectively. While we did not identify any associations between post-operative fluid overload and mortality/bronchopulmonary dysplasia in this cohort, we found that every 1% increase in weight gain within the first 3 days post-operation were associated with an increase in 0.6 day of invasive ventilator support (p=0.012) [Figure 2]. Such correlation still exists after adjusting for GA (p=0.033). Conclusion In our cohort of newborns undergoing abdominal surgery, weight gain within the first three post-operative days was associated with an increase in duration of invasive ventilator support. Fluid overload does not seem to be associated with acute kidney injury. Careful attention to intra and early postoperative fluid balance may play an important role in optimizing outcomes of newborns undergoing abdominal surgery.

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Serum symmetric dimethylarginine concentration in healthy horses and horses with acute kidney injury

BMC Veterinary Research ◽

10.1186/s12917-020-02621-y ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Natalia Siwinska ◽

Agnieszka Zak ◽

Malwina Slowikowska ◽

Artur Niedzwiedz ◽

Urszula Paslawska

Keyword(s):

Acute Kidney Injury ◽

Body Weight ◽

Serum Creatinine ◽

Healthy Adult ◽

Small Animal ◽

Kidney Injury ◽

Blood Analysis ◽

Advanced Degree ◽

Kidney Dysfunction ◽

Symmetric Dimethylarginine

Abstract Background There are limited options to diagnose acute kidney injury (AKI) in horses. Symmetric dimethylarginine (SDMA) is routinely used in human and small animal medicine. The aim of this study was to assess serum SDMA concentrations in healthy horses and horses with AKI. The objective of this study was to evaluate the association of: 1) age, 2) sex, 3) body weight and 4) serum creatinine and urea levels on serum SDMA concentrations. Fifty-three healthy horses, including 17 foals (2–6 months of age) and 36 adult horses (3–29 years of age), and 23 horses with AKI were included in the study based on history, physical examination, blood analysis, urinalysis and an ultrasonographic examination of the urinary tract. Serum SDMA concentrations were measured using a non-species specific commercial ELISA test. Results In healthy adult horses, the value of SDMA was 0.53 ± 0.14 μmol/L. The value was higher in foals (1.5 ± 0.4 μmol/L, P < 0.001). Horses with AKI had significantly higher concentrations of SDMA compared to healthy horses (1.76 ± 1.05 μmol/L, P < 0.001). In the healthy adult horses, there was no association of sex, age or body weight on SDMA. However, a significant positive relationship was found between serum creatinine and SDMA concentrations. Conclusions Healthy adult horses had SDMA values similar to those of other species. Foals had higher SDMA values. Therefore, different reference values should be created for them. The study confirmed an increased SDMA in horses with AKI. This, as well as the low influence of extrarenal factors on the SDMA values, may confirm its usefulness in the diagnosis of kidney dysfunction. Higher SDMA values may also indicate a more advanced degree of kidney dysfunction. Further research is required to determine whether SDMA could be used to detect kidney dysfunction in the asymptomatic stage of AKI.

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Myo-Inositol Oxygenase as a Novel Marker in the Diagnosis of Acute Kidney Injury

Journal of Medical Biochemistry ◽

10.1515/jomb-2017-0027 ◽

2018 ◽

Vol 37 (1) ◽

pp. 1-6

Author(s):

Cuma Mertoglu ◽

Murat Gunay ◽

Ali Gurel ◽

Mehmet Gungor

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Sensitivity And Specificity ◽

Cystatin C ◽

Area Under The Curve ◽

Kidney Injury ◽

Diagnostic Sensitivity ◽

Diagnostic Efficiency ◽

Characteristic Analysis ◽

Diagnostic Sensitivity And Specificity

SummaryBackground: Due to the lack of diagnostic efficiency of serum creatinine in acute kidney injury (AKI), there is a pressing need to develop novel diagnostic markers. Therefore, in this study, we evaluated myo-inositol oxygenase (MIOX), neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in terms of their applicability in the diagnosis of AKI. Methods: We enrolled a total of 39 AKI patients and 38 healthy controls in the study. We compared the levels of serum MIOX, NGAL and cystatin C between the two groups. Results: We found that the concentrations of serum creatinine, blood-urea nitrogen, MIOX and cystatin C were higher in the AKI group. According to the receiver operating characteristic analysis, the area under the curve (AUC) values were 0.694 (95% CI 0.579-0.794) for MIOX and 0.976 (95% CI; 0.912-0.997) for cystatin C. For MIOX, when the cut-off concentration was set to 77.3 pg/mL, the diagnostic sensitivity and specificity were found to be 53.8% (95% CI; 37.2-69.9) and 81.5 (95% CI; 65.7-92.3), respectively. For cystatin C, at the cut-off value of 14 mg/L, the diagnostic sensitivity and specificity were 94.8% (95% CI; 82.7-99.4) and 94.7 % (95% CI 82.3-99.4), respectively. Conclusion: The measurement of serum MIOX and cystatin C levels is valuable for the diagnosis of AKI. Further research is needed for the evaluation of the potential use of MIOX as a kidney-specific enzyme in the early diagnosis of AKI.

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