Urinary biomarkers for the differentiation of prerenal and intrinsic pediatric acute kidney injury
Urinary biomarkers for the differentiation of prerenal and intrinsic pediatric acute kidney injury
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区分肾前性和内源性小儿急性肾损伤的尿液生物标志物
DOI：
10.1007/s00467-016-3418-1
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发表时间：
2016
影响因子：
3
通讯作者：
Westhoff TH
中科院分区：
文献类型：
--
作者：
Westhoff JH;Fichtner A;Waldherr S;Pagonas N;Seibert FS;Babel N;Tönshoff B;Bauer F;Westhoff TH
尿钙保护蛋白和中性粒细胞明胶酶相关脂钙蛋白（NGAL）最近被确定为成人肾前性和内源性急性肾损伤（AKI）分化的有希望的生物标志物。在本文报道的研究中，我们检查了钙保护蛋白、NGAL和肾损伤分子1 （KIM-1）在儿科患者中的诊断准确性。方法对139名儿童受试者的血钙保护蛋白、NGAL和KIM-1浓度进行评估，其中包括39名内源性AKI患者、14名肾性AKI患者和86名非AKI患者。结果内源性AKI患者尿钙保护蛋白和NGAL浓度中位数高于肾前性AKI患者（钙保护蛋白和NGAL分别高出22倍和9倍）。受试者工作特征（ROC）曲线分析结果显示，钙保护蛋白的曲线下面积（AUC）为0.90[95%可信区间（CI） 0.81-0.98]， NGAL的曲线下面积（AUC）为0.73 （95% CI 0.58-0.87）。肾性AKI患者与内在疾病患者尿中位KIM-1浓度无显著差异（P= 0.98; AUC 0.50, 95% CI 0.35-0.65）。钠（fea）和蛋白尿的分数排泄AUC分别为0.78 （95% CI 0.63-0.92）和0.77 （95% CI 0.65-0.90）。结论尿钙保护蛋白优于NGAL、KIM-1、FENa和蛋白尿，可作为鉴别小儿肾前性AKI和内在性AKI的生物标志物，具有较高的诊断准确性。
BackgroundUrinary calprotectin and neutrophil gelatinase-associated lipocalin (NGAL) have recently been identified as promising biomarkers for the differentiation of prerenal and intrinsic acute kidney injury (AKI) in adults. In the study reported here we examined the diagnostic accuracy of calprotectin, NGAL, and kidney injury molecule 1 (KIM-1) in pediatric patients.MethodsUrinary calprotectin, NGAL, and KIM-1 concentrations were assessed in a study population of 139 pediatric subjects including 39 patients with intrinsic AKI, 14 with prerenal AKI, and 86 non-AKI subjects.ResultsMedian urinary calprotectin and NGAL concentrations were higher in patients with intrinsic AKI than in those with prerenal AKI (calprotectin by 22-fold, NGAL by 9-fold). Receiver operating characteristic (ROC) curve analyses for the differentiation of intrinsic and prerenal AKI resulted in an area under the curve (AUC) of 0.90 [95 % confidence interval (CI) 0.81–0.98] for calprotectin and 0.73 (95 % CI 0.58–0.87) for NGAL. Median urinary KIM-1 concentrations were not significantly different between patients with prerenal AKI and those with intrinsic disease (P= 0.98; AUC 0.50, 95 % CI, 0.35–0.65). The AUC for the fractional excretion of sodium (FENa) and proteinuria was 0.78 (95 % CI 0.63–0.92) and 0.77 (CI 0.65–0.90), respectively.ConclusionsUrinary calprotectin outperforms NGAL, KIM-1, FENa, and proteinuria as a biomarker for the differentiation of prerenal and intrinsic AKI in pediatric patients with a high diagnostic accuracy.
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影响因子：
4.4
作者：
L. Thurgood;R. Ryall
通讯作者：
L. Thurgood;R. Ryall
过敏性紫癜伴或不伴肾脏受累的 TLR-2 Arg753Gln、TLR-4 Asp299Gly 和 TLR-4 Thr399Ile 多态性
影响因子：
4
作者：
A. Soylu;S. Kızıldağ;S. Kavukçu;S. Cingöz;M. Türkmen;B. Demir;M. Sakızlı
通讯作者：
M. Sakızlı
影响因子：
19.6
作者：
通讯作者：
--
影响因子：
8
作者：
Selewski, David T.;Charlton, Jennifer R.;Kent, Alison L.
通讯作者：
Kent, Alison L.
影响因子：
19.6
作者：
Han, WK;Bailly, V;Bonventre, JV
通讯作者：
Bonventre, JV