Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates
Background: Asphyxia may lead to serious complications, among which acute kidney injury (AKI) is the most common. Early diagnosis of AKI can help prevent impaired acid-base, fluid, and electrolyte balance that may lead to life-threatening complications. This study aimed to evaluate the effect of kid...
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| Format: | Article |
| Language: | English |
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Mashhad University of Medical Sciences
2022-01-01
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| Series: | Iranian Journal of Neonatology |
| Subjects: | |
| Online Access: | https://ijn.mums.ac.ir/article_19171_99729aa6f22ebfd374160c2d31e139da.pdf |
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| author | Mahryar Mehrkesh Behzad Barekatain Alaleh Gheisari Mina Ahmadi Armindokht Shahsanai |
| author_facet | Mahryar Mehrkesh Behzad Barekatain Alaleh Gheisari Mina Ahmadi Armindokht Shahsanai |
| author_sort | Mahryar Mehrkesh |
| collection | DOAJ |
| description | Background: Asphyxia may lead to serious complications, among which acute kidney injury (AKI) is the most common. Early diagnosis of AKI can help prevent impaired acid-base, fluid, and electrolyte balance that may lead to life-threatening complications. This study aimed to evaluate the effect of kidney injury molecule-1 (KIM-1) and cystatin-C in the early diagnosis of AKI among asphyxiated neonates.
Methods: This case-control study was conducted on 45 asphyxiated neonates, 24 of whom were in the control group and 23 cases were in the case group. Creatinine (Cr), KIM-1, and cystatin-C were measured for participants within 8 h and 4 days after birth and compared between case and control groups.
Results: The mean level of Cr-Standardized KIM-1 measured within 8 h and 4 days after birth was significantly higher in the case group, compared to the control group (P-value<0.05). The mean level of Cr-Standardized cysteine, only 4 days after birth, was significantly higher in the case group, compared to the control group (P-value<0.05). A receiver operating characteristic (ROC) curve analysis demonstrated that between the two biomarkers with two measurements, the KIM-1 Cr-Standardized within 4 days had the highest area under the curve (AUC) (0.751, 95% CI: 0.597-0.905). Moreover, the results of ROC curve analysis showed that Cr-Standardized KIM-1 within 4 days after birth with a critical value of >0.67 ng/ml allowed to predict kidney failure in newborns with 57.1% sensitivity and 86.4% specificity.
Conclusion: The findings of the present study show that high-specificity KIM-1 is a good biomarker for the early detection of acute renal failure in asphyxiated infants; however, similar expectations cannot exist with regards to cystatin-C for at least the first 8 h after birth. |
| first_indexed | 2024-12-13T11:29:10Z |
| format | Article |
| id | doaj.art-6ebe76a7fe024b90ac8ba3b1c32a44cd |
| institution | Directory Open Access Journal |
| issn | 2251-7510 2322-2158 |
| language | English |
| last_indexed | 2024-12-13T11:29:10Z |
| publishDate | 2022-01-01 |
| publisher | Mashhad University of Medical Sciences |
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| series | Iranian Journal of Neonatology |
| spelling | doaj.art-6ebe76a7fe024b90ac8ba3b1c32a44cd2022-12-21T23:48:03ZengMashhad University of Medical SciencesIranian Journal of Neonatology2251-75102322-21582022-01-0113161210.22038/ijn.2021.58428.212619171Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated NeonatesMahryar Mehrkesh0Behzad Barekatain1Alaleh Gheisari2Mina Ahmadi3Armindokht Shahsanai4Department of Pediatrics, School of Medicine, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Pediatrics, School of Medicine, Al Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Pediatrics, School of Medicine, Kidney Diseases Research Center, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Pediatrics, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Social Medicine, Isfahan University of Medical Sciences, Isfahan, IranBackground: Asphyxia may lead to serious complications, among which acute kidney injury (AKI) is the most common. Early diagnosis of AKI can help prevent impaired acid-base, fluid, and electrolyte balance that may lead to life-threatening complications. This study aimed to evaluate the effect of kidney injury molecule-1 (KIM-1) and cystatin-C in the early diagnosis of AKI among asphyxiated neonates. Methods: This case-control study was conducted on 45 asphyxiated neonates, 24 of whom were in the control group and 23 cases were in the case group. Creatinine (Cr), KIM-1, and cystatin-C were measured for participants within 8 h and 4 days after birth and compared between case and control groups. Results: The mean level of Cr-Standardized KIM-1 measured within 8 h and 4 days after birth was significantly higher in the case group, compared to the control group (P-value<0.05). The mean level of Cr-Standardized cysteine, only 4 days after birth, was significantly higher in the case group, compared to the control group (P-value<0.05). A receiver operating characteristic (ROC) curve analysis demonstrated that between the two biomarkers with two measurements, the KIM-1 Cr-Standardized within 4 days had the highest area under the curve (AUC) (0.751, 95% CI: 0.597-0.905). Moreover, the results of ROC curve analysis showed that Cr-Standardized KIM-1 within 4 days after birth with a critical value of >0.67 ng/ml allowed to predict kidney failure in newborns with 57.1% sensitivity and 86.4% specificity. Conclusion: The findings of the present study show that high-specificity KIM-1 is a good biomarker for the early detection of acute renal failure in asphyxiated infants; however, similar expectations cannot exist with regards to cystatin-C for at least the first 8 h after birth.https://ijn.mums.ac.ir/article_19171_99729aa6f22ebfd374160c2d31e139da.pdfacute kidney injuryasphyxiacystatin-ckidney injury molecule-1 |
| spellingShingle | Mahryar Mehrkesh Behzad Barekatain Alaleh Gheisari Mina Ahmadi Armindokht Shahsanai Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates Iranian Journal of Neonatology acute kidney injury asphyxia cystatin-c kidney injury molecule-1 |
| title | Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates |
| title_full | Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates |
| title_fullStr | Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates |
| title_full_unstemmed | Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates |
| title_short | Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates |
| title_sort | serum kim 1 and cystatin levels as the predictors of acute kidney injury in asphyxiated neonates |
| topic | acute kidney injury asphyxia cystatin-c kidney injury molecule-1 |
| url | https://ijn.mums.ac.ir/article_19171_99729aa6f22ebfd374160c2d31e139da.pdf |
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