Is serum cystatin C a better marker of kidney function than serum creatinine in septic newborns?

Maruniak‐Chudek, Iwona; Owsianka-Podleśny, Teresa; Wróblewska, Jolanta; Jadamus-Niebrój, Danuta

doi:10.5604/17322693.988679

Cited by 21 publications

(15 citation statements)

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“…Elmas made similar observations, even when adjusting for respiratory distress syndrome [83]. However, these findings are in contrast to that of Maruniak-Chidek et al [84] and these authors question the validity of CysC as a marker of AKI in neonates. CysC concentrations may change with intravascular volume contraction [85], which frequently occurs in hypovolemic shock.…”

Section: The Problem Of Defining Acute Kidney Injury In Newbornsmentioning

confidence: 78%

Assessment of glomerular filtration rate in the neonate

Filler

Guerrero-Kanan

Álvarez-Elías

2016

Current Opinion in Pediatrics

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Section: The Problem Of Defining Acute Kidney Injury In Newbornsmentioning

confidence: 78%

Assessment of glomerular filtration rate in the neonate

Filler

Guerrero-Kanan

Álvarez-Elías

2016

Current Opinion in Pediatrics

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“…In search for specific disease characteristics, we retrieved information on the impact of gentamicin exposure, peripartal asphyxia, umbilical cord pH, congenital renal anomalies, renal dysfunction, respiratory distress with or without acute kidney injury, and sepsis/severe sepsis/septic shock on CysC measurements (Table 3) [25,29,30,33,36,38,39]. Cohorts were reported chronologically.…”

Section: Resultsmentioning

confidence: 99%

“…Even if we limit the analysis to blood samples in healthy term neonates in the first 24 h of life to restrict the impact of covariates, there is significant difference in mean values reported following PETIA [16,19,20] or ELISA [26] compared to PENIA assays [21,23,27,28,30], as illustrated in Figure 1. Finally, (iv) disease characteristics like respiratory distress [36], bilateral kidney abnormalities [25], peripartal asphyxia [30,38], aminoglycoside exposure [29], hemoglobin [30,38], renal dysfunction [33,37] or sepsis [39] also affect the CysC values observed, but not always in the expected direction. Aminoglycoside exposure in preterm neonates resulted in slightly lower serum CysC values, suggesting higher clearance [29].…”

Section: Discussion: How To Aim For a Moving Target?mentioning

confidence: 99%

“…Aminoglycoside exposure in preterm neonates resulted in slightly lower serum CysC values, suggesting higher clearance [29]. Similar, neonates in septic shock had lower CysC values when compared to neonates with (severe) sepsis [39]. This strongly suggests that besides aspects related to the CysC assay, additional clinical research is needed to document the potential add on benefit of more advanced biomarkers like CysC in neonatal medicine.…”

Section: Discussion: How To Aim For a Moving Target?mentioning

confidence: 99%

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Cystatin C in newborns: a promising renal biomarker in search for standardization and validation

Allegaert

Mekahli

Anker

2014

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective Neonatologists still commonly use creatinine as a proxy for renal clearance, despite issues related to neonatal (patho)physiology and methodology (assay variability). Cystatin C (CysC) has been suggested to be a more reliable biomarker, but assay related differences have also been reported in children and adults. We are unaware of any review on the assay related impact on CysC reference values in newborns. Methods A structured literature search was performed on published CysC values in (pre)term neonates. Results The extensive range (>5-fold) in serum CysC observations in neonates in part relates to the fact that CysC concentrations are higher at birth with subsequent decrease and that CysC concentrations are higher in preterm compared to term neonates. The CysC assay matters while disease characteristics also affect CysC values, but not always in the predicted direction. Conclusions Similar to creatinine, the extensive CysC range in neonates is only in part explained by renal (patho)physiology. Its applicability in neonatal medicine can be further improved by use of assay specific reference values, adapted to neonatal renal physiology (e.g. weight, age) and should be compared to a gold standard such as inulin clearance.

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“…16 Its usefulness was attracted by the lack of dependence from muscle mass, however, evidence supporting superiority over sCr are still elusive. [16][17][18][19][20][21] A new potential biomarker postulated as a more sensitive parameter of AKI is NGAL. 22 The introduction of this parameter into routine diagnostic workup requires establishing the reference values and knowledge of methodological limitations.…”

Section: Discussionmentioning

confidence: 99%

Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns

et al. 2015

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Background: Neutrophil gelatinase-associated lipocalin (NGAL) is postulated to be a highly sensitive and specific marker of acute kidney injury (AKI). The aim of this study was to assess the factors affecting serum and urine total NGAL in preterm newborns, limiting the role of this new potential marker of AKI. Methods: Serum and urinary total NGAL concentrations were determined in 57 preterm infants admitted to the Neonatal Intensive Care Unit in the following points of time: first week of life, between 8 and 14 days of life, and after the fourth week of life. Patients' clinical conditions were evaluated based on NTISS (Neonatal Therapeutic Intervention Scoring System). Two gestational age subgroups were distinguished: 29 and 30 to 35 weeks of gestation. We sought correlation between total NGAL values and gestational age, birth weight, Apgar score and severity of clinical condition, with particular interest in inflammatory status. Results: Serum and urinary total NGAL concentration correlated with inflammatory markers, such as CRP and procalcitonin, as well as with NTISS values. Birth weight and gestational age influence urinary NGAL (uNGAL) values in the first two weeks of life. In AKI (N ¼ 8) patients uNGAL values were significantly higher than in non-AKI newborns. Conclusions: We conclude that inflammatory status and prematurity limits the specificity of total NGAL measurement as a marker of AKI.

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Is serum cystatin C a better marker of kidney function than serum creatinine in septic newborns?

Abstract: Cystatin C is not a useful marker of kidney function in neonates with sepsis.

Cited by 21 publications

References 0 publications

Assessment of glomerular filtration rate in the neonate

Assessment of glomerular filtration rate in the neonate

Cystatin C in newborns: a promising renal biomarker in search for standardization and validation

Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns

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