Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates

Elsadek, Akram Elshafey; El-Gamasy, Mohamed Abdelaziz; Behiry, Eman G.; Torky, Ahmed; Fathy, Mohamed

doi:10.1016/j.jpurol.2019.12.001

Cited by 15 publications

(15 citation statements)

References 19 publications

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“…Initial screening identified 2,629 publications ( Figure 1 ). Finally, only 17 studies satisfied our inclusion criteria and were involved in the meta-analysis ( 2 , 4 – 6 , 12 , 20 – 31 ), including five cohort studies, ten case-control studies, and two cross-sectional studies ( Table 1 ). Of these, nine studies employed the KDIGO definition or the KDIGO definition modified for neonates (mKDIGO), six studies employed arbitrary definitions, and two studies employed the AKIN definition.…”

Section: Resultsmentioning

confidence: 99%

“… a Studies: I = ( 12 ); II = ( 22 ); III = ( 23 ); IV = ( 4 ); V = ( 24 ); VI = ( 25 ); VII = ( 26 ); VIII = ( 28 ); IX = ( 29 ); and X = ( 31 ) . ∧ One point .…”

Section: Resultsmentioning

confidence: 99%

“…Nowadays, the diagnosis of neonatal AKI has not been unified. There are five definitions that describe the state of neonatal AKI in our meta-analysis: (1) arbitrary definition mainly based on absolute serum creatinine (SCr) ≥1.5 mg/dl;( 4 , 23 , 24 , 27 ), (2) arbitrary definition based on absolute SCr >1 mg/dl and >1.3 mg/dl (for ≥33 weeks and <33 weeks, respectively) after 48 h of life;( 12 , 22 ), (3) AKIN definition based on absolute SCr ≥ 0.3mg/dl or SCr ≥1.5 times baseline within 48 h or urine volume <0.5 ml/kg/h for 6 h;( 11 , 21 , 25 ), (4) KDIGO definition based on absolute SCr ≥0.3 mg/dl within 48 h or SCr ≥1.5 times baseline, which is known or presumed within 7 days, or urine volume <0.5 ml/kg/h for 6 h;( 1 , 6 , 29 ), and (5) modified KDIGO definition changes the baseline to previous trough value in SCr ( 2 , 5 , 20 , 26 , 28 , 30 , 31 , 45 ). As we can see, the arbitrary definitions are mainly dependent on an absolute increase in SCr for at least 1 mg/dl, whose critical value is higher than that of AKIN and KDIGO.…”

Section: Discussionmentioning

confidence: 99%

“…Third, birth asphyxia was not included in this analysis for only one study that provided corresponding data ( 4 ). Fourth, among the 17 included studies, only 10 studies excluded congenital anomalies of the kidney and urinary tract ( 2 , 5 , 6 , 22 , 24 , 26 , 28 – 31 ), and 2 studies excluded lethal chromosomal anomaly ( 2 , 5 ), which may bring some bias to the results. Finally, the studies included have a large time span, and different clinical factors, such as different treatment methods, may bring some bias.…”

Section: Limitationsmentioning

confidence: 99%

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Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

Chen³

et al. 2021

Front. Pediatr.

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Background and Objective: Acute kidney injury (AKI) is recognized as an independent risk factor for mortality and long-term poor prognosis in neonates. The objective of the study was to identify the risk factors for AKI in critically ill neonates to provide an important basis for follow-up research studies and early prevention.Methods: The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Med, SinoMed, and VIP Data were searched for studies of risk factors in critically ill neonates. Studies published from the initiation of the database to November 19, 2020, were included. The quality of studies was assessed by the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality (AHRQ) checklist. The meta-analysis was conducted with Stata 15 and drafted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.Results: Seventeen studies (five cohort studies, ten case-control studies, and two cross-sectional studies) were included in meta-analysis, with 1,627 cases in the case group and 5,220 cases in the control group. The incidence of AKI fluctuated from 8.4 to 63.3%. Fifteen risk factors were included, nine of which were significantly associated with an increased risk of AKI in critically ill neonates: gestational age [standardized mean difference (SMD) = −0.31, 95%CI = (−0.51, −0.12), P = 0.002], birthweight [SMD = −0.37, 95%CI = (−0.67, −0.07), P = 0.015], 1-min Apgar score [SMD = −0.61, 95%CI = (−0.78, −0.43), P = 0.000], 5-min Apgar score [SMD = −0.71, 95%CI = (−1.00, −0.41), P = 0.000], congenital heart disease (CHD) [odds ratio (OR) = 2.94, 95%CI = (2.08, 4.15), P = 0.000], hyperbilirubinemia [OR = 2.26, 95%CI = (1.40, 3.65), P = 0.001], necrotizing enterocolitis (NEC) [OR = 6.32, 95%CI = (2.98, 13.42), P = 0.000], sepsis [OR = 2.21, 95%CI = (1.25, 3.89), P = 0.006], and mechanical ventilation [OR = 2.37, 95%CI = (1.50, 3.75), P = 0.000]. Six of them were not significantly associated with AKI in critically ill neonates: age [SMD = −0.25, 95%CI = (−0.54, 0.04), P = 0.095], male sex [OR = 1.10, 95%CI =(0.97, 1.24), P = 0.147], prematurity [OR = 0.90, 95%CI(0.52, 1.56), P = 0.716], cesarean section [OR = 1.52, 95%CI(0.77, 3.01), P = 0.234], prenatal hemorrhage [OR = 1.41, 95%CI = (0.86, 2.33), P = 0.171], and vancomycin [OR = 1.16, 95%CI = (0.71, 1.89), P = 0.555].Conclusions: This meta-analysis provides a preliminary exploration of risk factors in critically ill neonatal AKI, which may be useful for the prediction of AKI.Systematic Review Registration: PROSPERO (CRD42020188032).

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Section: Resultsmentioning

confidence: 99%

“… a Studies: I = ( 12 ); II = ( 22 ); III = ( 23 ); IV = ( 4 ); V = ( 24 ); VI = ( 25 ); VII = ( 26 ); VIII = ( 28 ); IX = ( 29 ); and X = ( 31 ) . ∧ One point .…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

Chen³

et al. 2021

Front. Pediatr.

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“…In addition, cystatin C is less likely to be influenced by muscle wasting, malnutrition, age and sex than creatinine, which indicates it may be more reliable and accurate in reflecting glomerular filtration rate (GFR) [12,[16][17][18]. Predictive value of serum cystatin C on evaluating occurrence of AKI has been confirmed in various groups of patients including critically ill patients, patients undergoing cardiac surgery and those receiving radiocontrast medium [19][20][21][22][23][24][25]. However, there are no studies exploring the association between serum cystatin C level and occurrence of AKI after TBI.…”

Section: Introductionmentioning

confidence: 99%

A nomogram based on serum cystatin C for predicting acute kidney injury in patients with traumatic brain injury

Wang

Gui

et al. 2021

Renal Failure

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Background Acute kidney injury (AKI) is a common complication in traumatic brain injury (TBI) patients and is associated with unfavorable outcome of these patients. We designed this study to explore the value of serum cystatin C, an indicator of renal function, on predicting AKI after suffering TBI. Methods Patients confirmed with TBI and hospitalized in the West China Hospital of Sichuan University between January 2015 and December 2019 were included. Patients were divided into two groups according to occurrence of AKI. Univariate and multivariate logistic regression analyses were sequentially utilized to find risk factors of AKI in included TBI patients. Nomogram composed of discovered risk factors for predicting AKI was constructed. Receiver operating characteristics (ROC) curves were drawn and area under the ROC curve (AUC) were calculated to evaluate the predictive value of cystatin C alone and the constructed nomogram. Results Among 234 included TBI patients, 55 were divided into AKI group. AKI group had shorter length of stay ( p < 0.001) and higher in-hospital mortality ( p < 0.001). Multivariate logistic regression analysis showed absolute lymphocyte count ( p = 0.034), serum creatinine ( p < 0.001), serum cystatin C ( p = 0.017) and transfusion of red blood cell ( p = 0.005) were independently associated with development of AKI after TBI. While hypertonic saline use was not associated with the development of AKI ( p = 0.067). The AUC of single cystatin C and predictive nomogram were 0.804 and 0.925, respectively. Conclusion Higher serum cystatin C is associated with development of AKI in TBI patients. Predictive nomogram incorporating cystatin C is beneficial for physicians to evaluate possibilities of AKI and consequently adjust treatment strategies to avoid occurrence of AKI.

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CKD Management Post-AKI: The Role of Biomarkers

Morgans

Warady

2021

Advances in Critical Care Pediatric Nephrology

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Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates

Cited by 15 publications

References 19 publications

Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

A nomogram based on serum cystatin C for predicting acute kidney injury in patients with traumatic brain injury

CKD Management Post-AKI: The Role of Biomarkers

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