Cystatin C compared to serum creatinine as a marker of acute kidney injury in critically ill neonates

Hidayati, Eka Laksmi; Utami, Meita Dwi; Rohsiswatmo, Rinawati; Tridjaja, Bambang

doi:10.1007/s00467-020-04668-3

Cited by 16 publications

(11 citation statements)

References 31 publications

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“…Currently, the diagnosis of AKI is still based on the changes in urine volume and serum creatine (sCr), which are recognized as insensitive in early diagnosis (11). In recent decades, many specialists have attempted to identify ideal biomarkers to predict AKI, and an increasing number of novel biomarkers, such as kidney injury molecular-1 and cystatin C, have been investigated for their value in early AKI detection (12)(13)(14). However, for some reason, they have not yet been widely applied in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke

Fen

Liu

et al. 2022

Front. Neurol.

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ObjectivesAcute kidney injury (AKI) is a serious complication of acute hemorrhagic stroke (AHS). Early detection and early treatment are crucial for patients with AKI. We conducted a study to analyze the role of the monocyte-to-lymphocyte ratio (MLR) in predicting the development of AKI after AHS.MethodsThis retrospective observational study enrolled all subjects with AHS who attended the neurosurgical intensive care unit (NSICU) at the First Affiliated University of South China between 2018 and 2021. Patient demographics, laboratory data, treatment details, and clinical outcomes were recorded.ResultsOf the 771 enrolled patients, 180 (23.3%) patients developed AKI. Compared to patients without AKI, those with AKI had a higher MLR and the neutrophil-lymphocyte ratio (NLR) at admission (P < 0.001). The MLR and the NLR at admission were associated with an increased AKI risk, with odds ratios (ORs) of 8.27 (95% CI: 4.23, 16.17, p < 0.001) and 1.17 (95% CI: 1.12, 1.22, p < 0.001), respectively. The receiver operating characteristic curve (ROC) analysis was conducted to analyze the ability of the MLR and NLR to predict AKI, and the areas under the curve (AUCs) of the MLR and the NLR were 0.73 (95% CI: 0.69, 0.77, p < 0.001) and 0.67 (95% CI: 0.62, 0.72, p < 0.001), with optimal cutoff values of 0.5556 and 11.65, respectively. The MLR and the NLR at admission were associated with an increased in-hospital mortality risk, with ORs of 3.13 (95% CI: 1.08, 9.04) and 1.07 (95% CI: 1.00, 1.14), respectively. The AUCs of the MLR and the NLR for predicting in-hospital mortality were 0.62 (95% CI: 0.54, 0.71, p = 0.004) and 0.52 (95% CI: 0.43, 0.62, p = 0.568), respectively. The optimal cutoff value for the MLR was 0.7059, with a sensitivity of 51% and a specificity of 73.3%.ConclusionsMLR and NLR measurements in patients with AHS at admission could be valuable tools for identifying patients at high risk of early AKI. The MLR was positively associated with in-hospital mortality and the NLR showed a weak ability for the prediction of in-hospital mortality.

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Section: Introductionmentioning

confidence: 99%

The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke

Fen

Liu

et al. 2022

Front. Neurol.

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“…Up until now, AKI has been defined by a rapid increase in serum Cr, a decrease in urine output, or both, indicating that Cr has a significantly predictive value for AKI [ 46 ]. Furthermore, Hidayati et al found that cystatin C was not superior to serum Cr in detecting neonatal AKI [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of an early warning model for predicting the acute kidney injury in elderly patients with sepsis

et al. 2022

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Background Sepsis-induced acute kidney injury (S-AKI) is a significant complication and is associated with an increased risk of mortality, especially in elderly patients with sepsis. However, there are no reliable and robust predictive models to identify high-risk patients likely to develop S-AKI. We aimed to develop a nomogram to predict S-AKI in elderly sepsis patients and help physicians make personalized management within 24 h of admission. Methods A total of 849 elderly sepsis patients from the First Affiliated Hospital of Xi’an Jiaotong University were identified and randomly divided into a training set (75%, n = 637) and a validation set (25%, n = 212). Univariate and multivariate logistic regression analyses were performed to identify the independent predictors of S-AKI. The corresponding nomogram was constructed based on those predictors. The calibration curve, receiver operating characteristics (ROC)curve, and decision curve analysis were performed to evaluate the nomogram. The secondary outcome was 30-day mortality and major adverse kidney events within 30 days (MAKE30). MAKE30 were a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD). Results The independent predictors for nomogram construction were mean arterial pressure (MAP), serum procalcitonin (PCT), and platelet (PLT), prothrombin time activity (PTA), albumin globulin ratio (AGR), and creatinine (Cr). The predictive model had satisfactory discrimination with an area under the curve (AUC) of 0.852–0.858 in the training and validation cohorts, respectively. The nomogram showed good calibration and clinical application according to the calibration curve and decision curve analysis. Furthermore, the prediction model had perfect predictive power for predicting 30-day mortality (AUC = 0.813) and MAKE30 (AUC = 0.823) in elderly sepsis patients. Conclusion The proposed nomogram can quickly and effectively predict S-AKI risk in elderly sepsis patients within 24 h after admission, providing information for clinicians to make personalized interventions.

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“… 30 Another report showed that serum Cys-C was also effective in diagnosing critically ill premature infants with AKI, with an SEN and SPE of 0.848, 0.618, and AUC of 0.849, but not better than SCr. 31 Compared with SCr, Cys-C seems to be a more specific and sensitive biomarker for urinary neutrophil gelatinase-associated lipocalin (NGIL) positive AKI in infants after cardiopulmonary bypass, with an SEN and SPE of 0.80 and 0.89 respectively and AUC of 0.87. 32 Additionally, a meta-analysis that included 24 articles (1948 children) showed the serum and urine levels of Cys-C were significantly higher in children with AKI.…”

Section: Discussionmentioning

confidence: 99%

Serum Cystatin C as a predictor of acute kidney injury in neonates: a meta-analysis

Yang

Lin²,

Zhuang³

et al. 2022

Jornal de Pediatria

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Cystatin C compared to serum creatinine as a marker of acute kidney injury in critically ill neonates

Cited by 16 publications

References 31 publications

The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke

The Monocyte-to-Lymphocyte Ratio Predicts Acute Kidney Injury After Acute Hemorrhagic Stroke

Construction and validation of an early warning model for predicting the acute kidney injury in elderly patients with sepsis

Serum Cystatin C as a predictor of acute kidney injury in neonates: a meta-analysis

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