Li QIAN, Rui CHENG, Chongwei WANG, et al. Clinical value of serum cystatin C in diagnosis of acute kidney injury associated with hyperbilirubinemia in full-term newborns[J]. Journal of Third Military Medical University, 2018, 40(2): 165-168.
DOI:
Li QIAN, Rui CHENG, Chongwei WANG, et al. Clinical value of serum cystatin C in diagnosis of acute kidney injury associated with hyperbilirubinemia in full-term newborns[J]. Journal of Third Military Medical University, 2018, 40(2): 165-168. DOI: 10.16016/j.1000-5404.201709195.
Clinical value of serum cystatin C in diagnosis of acute kidney injury associated with hyperbilirubinemia in full-term newborns
To study the value of serum cystatin C (CysC) in the diagnosis of acute kidney injury (AKI) associated with hyperbilirubinemia in full-term newborns.
Methods
2
A total of 217 full-term neonates with hyperbilirubinemia admitted in the Children's Hospital Affiliated to Nanjing Medical University over the period from June
2015 to June
2016 were enrolled in this study
including 46 with AKI and 171 without AKI. Another 52 healthy neonates were enrolled to serve as the normal control group.
Results
2
There were no significant differences in the levels of urea nitrogen
total protein
albumin or prealbumin among the 3 groups (
P
>
0.05). Compared with the normal control group
the neonates with hyperbilirubinemia had significantly elevated levels of total bilirubin
CysC
retinol binding protein and cholesterol (
P
<
0.05). The neonates with AKI showed significantly higher levels of CysC than those without AKI (
P
<
0.05). The optimal cutoff value of CysC for predicting AKI was 2.17 mg/L with an AUC of 0.845 (95%
CI
: 0.733~0.956
P
=0.000); at this cutoff value
CysC had a sensitivity of 82.6% (38/46) and a specificity of 70.9% (158/223) in predicting AKI in the neonates with hyperbilirubinemia.
Conclusion
2
Serum CysC can be used as an indicator for early detection of AKI associated with hyperbilirubinemia in neonates.
[Group of Neonates in the Chinese Academy of Pediatrics, Editorial Board of Chinese Journal of Pediatrics. Expert consensus on diagnoses and treatment in hyperbilirubinemia of newborn[J ] . Chin J Pediatr, 2014, 52(10): 745-748. DOI: 10.3760/cma.j.issn.0578-1310.2014.10.006. http://dx.doi.org/10.3760/cma.j.issn.0578-1310.2014.10.006.
SUN X F, YU Z B, DONG X Y, et al .Current situation in hyperbilirubinemia of newborn before and after the new management m easure[J ] .Chin J Perinat Med, 2016, 19(11): 819-822.doi:10.3760/cma.j.issn.1007-9408.2016.11.006.
[INGELFINGER J R, KALANTAR-ZADEH K, SCHAEFER F. for the World Kidney Day Steering Committee. Averting the legacy of kidney disease-focus on childhood. Kidney Int. 2016;89: 512-518[J ] . Kidney Int, 2016, 89(6): 1405. DOI: 10.1016/j.kint.2016.04.001. http://dx.doi.org/10.1016/j.kint.2016.04.001.
HERBERT C, PATEL M, NUGENT A, et al .Serum Cystatin C as an Early Marker of Neutrophil Gelatinase-associated Lipocalin-positive Acute Kidney Injury Resulting from Cardiopulmonary Bypass in Infants with Congenital Heart Disease[J ] .Congenit Heart Dis, 2015, 10(4): E180-E188.DOI:10.1111/chd.12253.
ASKENAZI D J, KORALKAR R, HUNDLEY H E, et al .Urine biomarkers predict acute kidney injury in newborns[J ] . J Pediatr, 2012, 161(2): 270-275.DOI:10.1016/j.jpeds.2012.02.007.
SWEETMAN D U, ONWUNEME C, WATSON W R, et al .Renal function and novel urinary biomarkers in infants with neonatal encephalopathy[J ] .Acta Paediatr, 2016, 105(11): e513-e519.DOI:10.1111/apa.13555.
Subcommittee on Hyperbilirubinemia.Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation[J].Pediatrics, 2004, 114(1): 297-316.
NOVO A C, SADECK LDOS S, OKAY T S, et al .Longitudinal study of Cystatin C in healthy term newborns[J ] .Clinics (Sao Paulo), 2011, 66(2): 217-220.DOI:10.1590/s1807-59322011000200006.
MCCAFFREY J, COUPES B, CHALONER C, et al .Towards a biomarker panel for the assessment of AKI in children receiving intensive care[J ] .Pediatr Nephrol, 2015, 30(10): 1861-1871.DOI:10.1007/s00467-015-3089-3.
TURKEL S B.Autopsy findings associated with neonatal hyperbilirubinemia[J].Clin Perinatol, 1990, 17(2): 381-396.
CHENG B, JIN Y, LIU G, et al .Urinary N-acetyl-beta-D-glucosaminidase as an early marker for acute kidney injury in full-term newborns with neonatal hyperbilirubinemia[J ] .Dis Markers, 2014, 2014: 315843.DOI:10.1155/2014/315843.
BETJES M G, BAJEMA I.The pathology of jaundice-related renal insufficiency: cholemic nephrosis revisited[J]. J Nephrol, 2006, 19(2): 229-233.
SUN L, GUO W, PAN B S.Research progress of acute kidney injury biomarkers[J].Chin J Lab Med, 2014, 37(6): 425-429.DOI: 10.3760/cma.j.issn.1009-9158.2014.06.007.
CHENG B, JIN Y, LIU G, et al .Urinary N-acetyl-beta-D-glucosaminidase as an early marker for acute kidney injury in full-term newborns with neonatal hyperbilirubinemia[J ] .Dis Markers, 2014, 2014: 315843.DOI: 10.1155/2014/315843.
TUNG Y C, CHANG C H, CHEN Y C, et al .Combined biomarker analysis for risk of acute kidney injury in patients with ST-segment elevation myocardial infarction[J ] .PLoS ONE, 2015, 10(4): e0125282.DOI: 10.1371/journal.pone.0125282.
WAN Z H.Cystatin C is a biomarker for predicting acute kidney injury in patients with acute-on-chronic liver failure[J].World Journal of Gastroenterology, 2013, 19(48): 9432.DOI: 10.3748/wjg.v19.i48.9432.
ZHANG Z, XU X, NI H, et al .Serum cystatin C is associated with renal function recovery in critically ill patients undergoing continuous renal replacement therapy[J ] .Nephron Clin Pract, 2012, 122(3-4): 86-92.DOI: 10.1159/000350245.
GAYGISIZ Ü, AYDO GǦDU M, BADO GǦLU M, et al .Can admission serum cystatin C level be an early marker subclinical acute kidney injury in critical care patients[J ] .Scand J Clin Lab Invest, 2016, 76(2): 143-150.DOI: 10.3109/00365513.2015.1126854.
ARGYRI I, XANTHOS T, VARSAMI M, et al .The role of novel biomarkers in early diagnosis and prognosis of acute kidney injury in newborns[J ] .Am J Perinatol, 2013, 30(5): 347-352.DOI: 10.1055/s-0032-1326985.