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Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome

Puumala orthohantavirus causes hemorrhagic fever with renal syndrome (HFRS) characterized by acute kidney injury (AKI), an abrupt decrease in renal function. Creatinine is routinely used to detect and quantify AKI; however, early AKI may not be reflected in increased creatinine levels. Therefore, ki...

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Autores principales: Hansson, Magnus, Gustafsson, Rasmus, Jacquet, Chloé, Chebaane, Nedia, Satchell, Simon, Thunberg, Therese, Ahlm, Clas, Fors Connolly, Anne-Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460112/
https://www.ncbi.nlm.nih.gov/pubmed/32824680
http://dx.doi.org/10.3390/pathogens9080666
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author Hansson, Magnus
Gustafsson, Rasmus
Jacquet, Chloé
Chebaane, Nedia
Satchell, Simon
Thunberg, Therese
Ahlm, Clas
Fors Connolly, Anne-Marie
author_facet Hansson, Magnus
Gustafsson, Rasmus
Jacquet, Chloé
Chebaane, Nedia
Satchell, Simon
Thunberg, Therese
Ahlm, Clas
Fors Connolly, Anne-Marie
author_sort Hansson, Magnus
collection PubMed
description Puumala orthohantavirus causes hemorrhagic fever with renal syndrome (HFRS) characterized by acute kidney injury (AKI), an abrupt decrease in renal function. Creatinine is routinely used to detect and quantify AKI; however, early AKI may not be reflected in increased creatinine levels. Therefore, kidney injury markers that can predict AKI are needed. The potential of the kidney injury markers urea, cystatin C, α1-microglobulin (A1M) and neutrophil gelatinase-associated lipocalin (NGAL) to detect early AKI during HFRS was studied by quantifying the levels of these markers in consecutively obtained plasma (P) and urine samples (U) for 44 HFRS patients. P-cystatin C and U-A1M levels were significantly increased during early HFRS compared to follow-up. In a receiver operating characteristic (ROC) curve analysis, P-cystatin C, U-A1M and P-urea predicted severe AKI with area under the curve 0.72, 0.73 and 0.71, respectively, whereas the traditional kidney injury biomarkers creatinine and U-albumin did not predict AKI. Nearly half of the HFRS patients (41%) fulfilled the criteria for shrunken pore syndrome, which was associated with the level of inflammation as measured by P-CRP. P-cystatin C and U-A1M are more sensitive and earlier markers compared to creatinine in predicting kidney injury during HFRS.
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spelling pubmed-74601122020-09-02 Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome Hansson, Magnus Gustafsson, Rasmus Jacquet, Chloé Chebaane, Nedia Satchell, Simon Thunberg, Therese Ahlm, Clas Fors Connolly, Anne-Marie Pathogens Article Puumala orthohantavirus causes hemorrhagic fever with renal syndrome (HFRS) characterized by acute kidney injury (AKI), an abrupt decrease in renal function. Creatinine is routinely used to detect and quantify AKI; however, early AKI may not be reflected in increased creatinine levels. Therefore, kidney injury markers that can predict AKI are needed. The potential of the kidney injury markers urea, cystatin C, α1-microglobulin (A1M) and neutrophil gelatinase-associated lipocalin (NGAL) to detect early AKI during HFRS was studied by quantifying the levels of these markers in consecutively obtained plasma (P) and urine samples (U) for 44 HFRS patients. P-cystatin C and U-A1M levels were significantly increased during early HFRS compared to follow-up. In a receiver operating characteristic (ROC) curve analysis, P-cystatin C, U-A1M and P-urea predicted severe AKI with area under the curve 0.72, 0.73 and 0.71, respectively, whereas the traditional kidney injury biomarkers creatinine and U-albumin did not predict AKI. Nearly half of the HFRS patients (41%) fulfilled the criteria for shrunken pore syndrome, which was associated with the level of inflammation as measured by P-CRP. P-cystatin C and U-A1M are more sensitive and earlier markers compared to creatinine in predicting kidney injury during HFRS. MDPI 2020-08-18 /pmc/articles/PMC7460112/ /pubmed/32824680 http://dx.doi.org/10.3390/pathogens9080666 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
Hansson, Magnus
Gustafsson, Rasmus
Jacquet, Chloé
Chebaane, Nedia
Satchell, Simon
Thunberg, Therese
Ahlm, Clas
Fors Connolly, Anne-Marie
Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome
title Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome
title_full Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome
title_fullStr Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome
title_full_unstemmed Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome
title_short Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome
title_sort cystatin c and α-1-microglobulin predict severe acute kidney injury in patients with hemorrhagic fever with renal syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460112/
https://www.ncbi.nlm.nih.gov/pubmed/32824680
http://dx.doi.org/10.3390/pathogens9080666
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