Pediatric reference ranges for acute kidney injury biomarkers.
Pediatric reference ranges for acute kidney injury biomarkers.
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DOI：
10.1007/s00467-014-2989-y
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发表时间：
2015-04
期刊：
影响因子：
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通讯作者：
Devarajan P
中科院分区：
文献类型：
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作者：
Bennett MR;Nehus E;Haffner C;Ma Q;Devarajan P
新的尿生物标志物可用于预测急性肾损伤（阿基）。最有希望的是尿液标记物NGAL、IL-18、KIM-1和LFABP。使用疾病对照，这些方法中的每一种都显示出比血清肌酐（Scr）更早诊断阿基的相当大的前景。我们着手确定健康儿科人群中这些标志物的参考水平。从368名健康儿童收集尿液，并使用市售试剂盒或测定材料测定NGAL、IL-18、KIM-1和LFABP。通过线性回归并根据年龄组（3-<5岁; 5-<10岁; 10-<15岁; 15-<18岁）进行生物标志物的分析，以确定生物标志物水平是否随年龄和性别而不同。中位值为：NGAL（6.6 ng/ml; IQR 2.8-17）、IL-18（21.6 pg/ml; IQR 13.6-32.9）、KIM-1（410 pg/ml; IQR 226-703）、LFABP（3.4 ng/ml; IQR 1.6-6.0）。NGAL和IL-18存在显著的性别差异，所有标志物均存在显著的年龄差异。每个标记物的第95百分位值随年龄和性别而变化，大于中位数值。这是NGAL、IL-18、KIM-1和LFABP尿液测量的最大儿科参考范围研究，并强调了这些标志物的年龄和性别差异。这些信息对于合理解释利用这些新兴阿基生物标志物的研究和临床试验至关重要。
Novel urinary biomarkers are useful for the prediction of acute kidney injury (AKI). Most promising are the urine markers NGAL, IL-18, KIM-1, and LFABP. Each of these has shown considerable promise diagnosing AKI earlier than serum creatinine (Scr) using disease controls. We set out to determine reference levels of these markers in a healthy pediatric population. Urine was collected from 368 healthy children and assayed for NGAL, IL-18, KIM-1, and LFABP using commercially available kits or assay materials. Analysis of biomarkers by linear regression and according to age groups (3–<5 years; 5–<10; 10–<15; 15–<18) was performed to determine if biomarker levels differed with age and gender. Median values were: NGAL (6.6 ng/ml; IQR 2.8–17), IL-18 (21.6 pg/ml; IQR 13.6–32.9), KIM-1 (410 pg/ml; IQR 226–703), LFABP (3.4 ng/ml; IQR 1.6–6.0). Significant gender differences were found with NGAL and IL-18 and significant age differences were found with all markers. 95th percentile values for each marker varied with age and gender greater than median values. This is the largest pediatric reference range study for the urinary measurement of NGAL, IL-18, KIM-1, and LFABP and highlights age and gender differences in these markers. This information is essential for rational interpretation of studies and clinical trials utilizing these emerging AKI biomarkers.