Serum cystatin C for acute kidney injury evaluation in children treated with aminoglycosides.
Pediatr Nephrol
; 32(1): 163-171, 2017 01.
Article
em En
| MEDLINE
| ID: mdl-27743042
ABSTRACT
BACKGROUND:
Serum cystatin C (CysC) is a more accurate glomerular filtration rate marker than serum creatinine (SCr) and may rise more quickly with acute kidney injury (AKI).METHODS:
We performed a prospective cohort study of 81 non-critically ill children during 110 aminoglycoside (AG) treatments. We calculated area under the curve (AUC) for CysC to diagnose SCr-defined AKI and predict persistent AKI. SCr-AKI definition was based on the Kidney Disease Improving Global Outcomes (≥stage 1 ≥50 % or 26.5 µmol/l SCr rise from baseline; stage 2 SCr doubling); CysC-AKI was based on a modified version using CysC rise.RESULTS:
SCr-AKI and CysC-AKI developed in 45 and 48 % treatments, respectively. CysC rise predicted stage 1 (AUC = 0.75, 95 % CI 0.60-0.90) and 2 (AUC = 0.85, 95 % CI 0.75-0.95) SCr-AKI 2 days before SCr-AKI attainment. The best combined sensitivity/specificity for percent CysC rise to predict stage 1 SCr-AKI was with a 44 % CysC rise (sensitivity = 65 %, specificity = 83 %). CysC rise on day of SCr-AKI development was associated with SCr-AKI ≥48 h (AUC = 0.73, 95 % CI 0.56-0.90) and ≥50 % persistent SCr rise at treatment end (AUC = 0.76, 95 % CI 0.61-0.90).CONCLUSIONS:
CysC is as an early AKI biomarker and predictive of persistent AKI on aminoglycoside treatment.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cistatina C
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Injúria Renal Aguda
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Aminoglicosídeos
/
Antibacterianos
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
Pediatr Nephrol
Assunto da revista:
NEFROLOGIA
/
PEDIATRIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Canadá