Urinary neutrophil gelatinase-associated lipocalin(NGAL)and serum cystatin C measurements for early diagnosis of acute kidney injury in children admitted to PICU

作     者：Jameela Abdulaziz Kari Mohamed Ahmed Shalaby Kholoud Sofyani Ahmad Saleh Sanad Albaraa Fuad Ossra Rayan Smeer Halabi Maha Hassan Aljuhani Wael Mohammad Toffaha Feras Aymen Moria Samar Sabry Hanan AbdelAziz Ahmed Khalid Abdulaziz Alhasan Sara Sharief Osama Safdar Jameela Abdulaziz Kari;Mohamed Ahmed Shalaby;Kholoud Sofyani;Ahmad Saleh Sanad;Albaraa Fuad Ossra;Rayan Smeer Halabi;Maha Hassan Aljuhani;Wael Mohammad Toffaha;Feras Aymen Moria;Samar Sabry;Hanan AbdelAziz Ahmed;Khalid Abdulaziz Alhasan;Sara Sharief;Osama Safdar

作者机构：Pediatric Nephrology Center of Excellence and Department of PediatricsKing Abdulaziz University80215Jeddah 21589Kingdom of Saudi Arabia Pediatric Intensive Care UnitDepartment of PediatricsKing Abdulaziz UniversityJeddahKingdom of Saudi Arabia Pediatric DepartmentCairo UniversityGizaEgypt Department of PediatricsCollege of MedicineKing Khalid University HospitalKing Saud UniversityRiyadhKingdom of Saudi Arabia 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2018年第14卷第2期

页      面：134-142页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：funded by the King Abdulaziz City for Science and Technology(KACST)under grand number 27-35-T-A(27-35-■■) 

主　　题：Acute kidney injury Neutrophil gelatinase-associated lipocalin Serum cystatin C 

摘      要：Background Acute kidney injury(AKI)is common in critically ill children with significant mortality and *** creatinine is an insensitive and late biomarker compared to newly proposed AKI *** Prospective study in pediatric intensive care unit(PICU)over three months to compare between serum cystatin-C(s-Cys-C)and urinary neutrophil gelatinase-associated lipocalin(uNGAL)as AKI biomarkers at multiple time points with pediatric risk,injury,failure,loss,end-stage renal disease(pRIFLE)classification in diagnosing *** Forty children were *** these 40 children,22 developed AKI according to pRIFLE *** was no significant difference between AKI and non-AKI in age(P=0.29).Post cardiac surgery,renal insult was the main cause of AKI(27.3%).There was a twofold increased risk of incident AKI in those patients with high baseline uNGAL at PICU admission and almost a fourfold increased risk in patients with high baseline s-Cys-C at PICU *** levels were highly predictive of AKI during the follow-up period[area under the curve(AUC)=0.76,95%confidence interval(CI)0.61-0.92].The cutoff point with the highest correctly classified proportion was 223 ng/mL(≥12 centiles)which correctly predict 80.0%patients with AKI,with a corresponding sensitivity of 72.7%and a specificity of 89.9%.AUC for s-Cys-C was 0.86(95%CI 0.75-0.97),and the highest correctly classified proportion was 1009μg/L(≥13 centiles);75%of patients with AKI,with a corresponding sensitivity of 63.6%and a specificity of 88.9%.Conclusion uNGAL and s-Cys-C predicts AKI early in critically ill children.