Serum cystatin is a useful marker for the diagnosis of acute kidney injury in critically ill children: prospective cohort study

BMC Nephrology

Research Article

Mafaza Saber¹  Bassem Elattal¹  Esraa Bukahri¹  Roaa Awleyakhan¹  Hala Aljariry¹  Safaa Gasim¹  Arwa Alahadal¹  Mohammed Bin Joubah¹  Afnan Hadadi²  Norah Khathlan³  Abdullah Alqahtani⁴  Jameela A. Kari⁵  Mohammed Shalaby⁵  Osama Y. Safdar⁶ 

[1] Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia;College of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;Intensive Care Unit, Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia;Pediatric Nephrology Unit, Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;Pediatric Nephrology Unit, Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;Pediatric Department, King Abdulaziz University Hospital, P.O. Box 14071, Alsulimania, 21414, Jeddah, Kingdom of Saudi Arabia;

关键词: Pediatric;    Acute kidney injury;    Cystatin C;    Creatinine;   

DOI  :  10.1186/s12882-016-0346-z

 received in 2015-08-11, accepted in 2016-09-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAcute kidney injury (AKI) has been associated with high morbidity and mortality rates among critically ill children. Cystatin C is a protease inhibitor, and studies have shown that it is a promising marker for the early diagnosis of AKI. Our goal in this study was to assess whether serum cystatin C could serve as an accurate marker for the diagnosis of AKI.MethodsThis prospective study was undertaken in the pediatric intensive care unit at King Abdulaziz University Hospital. Serum creatinine and serum cystatin C levels were both measured in patients on admission (0 h) and at 6, 12, and 24 h after admission. AKI was diagnosed according to the modified pRIFLE criteria. Receiver operating characteristic (ROC) curve analysis was performed to assess the utility of serum cystatin C for diagnosing AKI.ResultsA total of 62 patients were enrolled in this study, and 32 were diagnosed with AKI according to the modified pRIFLE criteria (51.4 %). The area under the ROC curve for serum cystatin indicated that it was a good marker for the diagnosis of AKI at 0, 6, 12 and 24 h, with sensitivities of 78, 94, 94 and 83 %, respectively. However, the specificities of serum cystatin C at 0, 6, 12, and 24 h were 57, 57, 60 and 50 %, respectively. The optimal cutoff value was 0.645 mg/L. The area under the ROC for serum creatinine showed sensitivities of 50, 65.4, 69.2 and 57.7 % and specificities of 67.7, 70, 60 and 70 % at 0, 6, 12 and 24 h, respectively. The optimal cutoff value for serum creatinine was 30 μmol/l. Comparisons of ROC curves revealed that serum cystatin C was superior to serum creatinine for the diagnosis of AKI at 12 h (p = 0.03), but no differences were detected at 0, 6 or 24 h.ConclusionSerum cystatin is a sensitive, but not a specific, marker for the diagnosis of AKI in critically ill children.

【 授权许可】

CC BY   
© The Author(s). 2016