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Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study

Acute kidney injury (AKI) in critically ill children and adults is associated with significant short- and long-term morbidity and mortality. As serum creatinine- and urine output-based definitions of AKI have relevant limitations, there is a persistent need for better diagnostics of AKI. Nuclear mag...

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Autores principales: Muhle-Goll, Claudia, Eisenmann, Philipp, Luy, Burkhard, Kölker, Stefan, Tönshoff, Burkhard, Fichtner, Alexander, Westhoff, Jens H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072839/
https://www.ncbi.nlm.nih.gov/pubmed/32054020
http://dx.doi.org/10.3390/ijms21041187
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author Muhle-Goll, Claudia
Eisenmann, Philipp
Luy, Burkhard
Kölker, Stefan
Tönshoff, Burkhard
Fichtner, Alexander
Westhoff, Jens H.
author_facet Muhle-Goll, Claudia
Eisenmann, Philipp
Luy, Burkhard
Kölker, Stefan
Tönshoff, Burkhard
Fichtner, Alexander
Westhoff, Jens H.
author_sort Muhle-Goll, Claudia
collection PubMed
description Acute kidney injury (AKI) in critically ill children and adults is associated with significant short- and long-term morbidity and mortality. As serum creatinine- and urine output-based definitions of AKI have relevant limitations, there is a persistent need for better diagnostics of AKI. Nuclear magnetic resonance (NMR) spectroscopy allows for analysis of metabolic profiles without extensive sample manipulations. In the study reported here, we examined the diagnostic accuracy of NMR urine metabolite patterns for the diagnosis of neonatal and pediatric AKI according to the Kidney Disease: Improving Global Outcomes (KDIGO) definition. A cohort of 65 neonatal and pediatric patients (0–18 years) with established AKI of heterogeneous etiology was compared to both a group of apparently healthy children (n = 53) and a group of critically ill children without AKI (n = 31). Multivariate analysis identified a panel of four metabolites that allowed diagnosis of AKI with an area under the receiver operating characteristics curve (AUC-ROC) of 0.95 (95% confidence interval 0.86–1.00). Especially urinary citrate levels were significantly reduced whereas leucine and valine levels were elevated. Metabolomic differentiation of AKI causes appeared promising but these results need to be validated in larger studies. In conclusion, this study shows that NMR spectroscopy yields high diagnostic accuracy for AKI in pediatric patients.
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spelling pubmed-70728392020-03-19 Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study Muhle-Goll, Claudia Eisenmann, Philipp Luy, Burkhard Kölker, Stefan Tönshoff, Burkhard Fichtner, Alexander Westhoff, Jens H. Int J Mol Sci Article Acute kidney injury (AKI) in critically ill children and adults is associated with significant short- and long-term morbidity and mortality. As serum creatinine- and urine output-based definitions of AKI have relevant limitations, there is a persistent need for better diagnostics of AKI. Nuclear magnetic resonance (NMR) spectroscopy allows for analysis of metabolic profiles without extensive sample manipulations. In the study reported here, we examined the diagnostic accuracy of NMR urine metabolite patterns for the diagnosis of neonatal and pediatric AKI according to the Kidney Disease: Improving Global Outcomes (KDIGO) definition. A cohort of 65 neonatal and pediatric patients (0–18 years) with established AKI of heterogeneous etiology was compared to both a group of apparently healthy children (n = 53) and a group of critically ill children without AKI (n = 31). Multivariate analysis identified a panel of four metabolites that allowed diagnosis of AKI with an area under the receiver operating characteristics curve (AUC-ROC) of 0.95 (95% confidence interval 0.86–1.00). Especially urinary citrate levels were significantly reduced whereas leucine and valine levels were elevated. Metabolomic differentiation of AKI causes appeared promising but these results need to be validated in larger studies. In conclusion, this study shows that NMR spectroscopy yields high diagnostic accuracy for AKI in pediatric patients. MDPI 2020-02-11 /pmc/articles/PMC7072839/ /pubmed/32054020 http://dx.doi.org/10.3390/ijms21041187 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Muhle-Goll, Claudia
Eisenmann, Philipp
Luy, Burkhard
Kölker, Stefan
Tönshoff, Burkhard
Fichtner, Alexander
Westhoff, Jens H.
Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study
title Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study
title_full Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study
title_fullStr Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study
title_full_unstemmed Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study
title_short Urinary NMR Profiling in Pediatric Acute Kidney Injury—A Pilot Study
title_sort urinary nmr profiling in pediatric acute kidney injury—a pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072839/
https://www.ncbi.nlm.nih.gov/pubmed/32054020
http://dx.doi.org/10.3390/ijms21041187
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