Accuracy of cystatin C in prediction of acute kidney injury in children; serum or urine levels: which one works better? A systematic review and meta-analysis.
BMC Nephrol
; 18(1): 120, 2017 04 03.
Article
em En
| MEDLINE
| ID: mdl-28372557
ABSTRACT
BACKGROUND:
There is still an ongoing discussion on the prognostic value of cystatin C in assessment of kidney function. Accordingly, the present study aimed to conduct a meta-analysis to provide evidence for the prognostic value of this biomarker for acute kidney injury (AKI) in children.METHODS:
An extensive search was performed in electronic databases of Medline, Embase, ISI Web of Science, Cochrane library and Scopus until the end of 2015. Standardized mean difference (SMD) with a 95% of confidence interval (95% CI) and the prognostic performance characteristics of cystatin C in prediction of AKI were assessed. Analyses were stratified based on the sample in which the level of cystatin C was measured (serum vs. urine).RESULTS:
A total of 24 articles were included in the meta-analysis [1948 children (1302 non-AKI children and 645 AKI cases)]. Serum (SMD = 0.96; 95% CI 0.68-1.24; p < 0.0001) and urine (SMD = 0.54; 95% CI0.34-0.75; p < 0.0001) levels of cystatin C were significantly higher in children with AKI. Overall area under the curve of serum cystatin C and urine cystatin C in prediction of AKI were 0.83 (95% CI 0.80-0.86) and 0.85 (95% CI 0.81-0.88), respectively. The best sensitivity (value = 0.85; 95% CI 0.78-0.90) and specificity (value = 0.61; 95% CI 0.48-0.73), were observed for the serum concentration of this protein and in the cut-off points between 0.4-1.0 mg/L.CONCLUSION:
The findings of the present study showed that cystatin C has an acceptable prognostic value for prediction of AKI in children. Since the serum level of cystatin C rises within the first 24 h of admission in patients with AKI, this biomarker can be a suitable alternative for traditional diagnostic measures.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cistatina C
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Injúria Renal Aguda
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Adolescent
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Child
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Child, preschool
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Humans
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Infant
Idioma:
En
Revista:
BMC Nephrol
Assunto da revista:
NEFROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Irã