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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7072839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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