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uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children

Acute kidney injury (AKI) occurs frequently in critically ill children, having an incidence of up to 26.9% and is associated with high morbidity and mortality in pediatric intensive care units (PICU). Currently, the decrease in the glomerular filtration rate is calculated using the serum creatinine...

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Autores principales: Gavrilovici, Cristina, Duşa, Cristian Petru, Mihai, Cosmin Teodor, Spoială, Elena-Lia, Stârcea, Iuliana Magdalena, Iliescu-Halitchi, Codruta Olimpiada, Zetu, Irina Nicoleta, Ionescu, Lavinia Bodescu-Amancei, Bogos, Roxana Alexandra, Hanganu, Elena, Boiculese, Vasile Lucian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407884/
https://www.ncbi.nlm.nih.gov/pubmed/36011231
http://dx.doi.org/10.3390/healthcare10081575
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author Gavrilovici, Cristina
Duşa, Cristian Petru
Mihai, Cosmin Teodor
Spoială, Elena-Lia
Stârcea, Iuliana Magdalena
Iliescu-Halitchi, Codruta Olimpiada
Zetu, Irina Nicoleta
Ionescu, Lavinia Bodescu-Amancei
Bogos, Roxana Alexandra
Hanganu, Elena
Boiculese, Vasile Lucian
author_facet Gavrilovici, Cristina
Duşa, Cristian Petru
Mihai, Cosmin Teodor
Spoială, Elena-Lia
Stârcea, Iuliana Magdalena
Iliescu-Halitchi, Codruta Olimpiada
Zetu, Irina Nicoleta
Ionescu, Lavinia Bodescu-Amancei
Bogos, Roxana Alexandra
Hanganu, Elena
Boiculese, Vasile Lucian
author_sort Gavrilovici, Cristina
collection PubMed
description Acute kidney injury (AKI) occurs frequently in critically ill children, having an incidence of up to 26.9% and is associated with high morbidity and mortality in pediatric intensive care units (PICU). Currently, the decrease in the glomerular filtration rate is calculated using the serum creatinine levels. Nevertheless, there may be a 48 h delay between the renal injury and measurable increase in creatinine. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been validated in relation to cardiopulmonary bypass in children, being able to detect AKI before the functional change proven by the rise in serum creatinine. Our aim was to study the utility of using uNGAL in the management of critical pediatric patients admitted to our hospital in a six month period, more specifically, its capacity to predict AKI development, alone and in the association with the renal angina index (RAI). Twenty-eight critically ill children aged from 1 day to 15 years have been included. We found that an increase in uNGAL in day 1 of admission in the PICU was significantly correlated with a decrease in creatinine clearance but not anymore in day 3. However, in our sample uNGAL did not show a significant predictability for AKI development nor the supplementary incorporation of RAI into the prediction model. Therefore, apart from cardiac surgery, the efficacy and utility or uNGAL in the management of critically ill children is still questionable. For the best prediction, we will need to incorporate not only the RAI or other PICU scores, but other biomarkers such as KIM-1, urinary cystatin, and IL 18 in larger samples.
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spelling pubmed-94078842022-08-26 uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children Gavrilovici, Cristina Duşa, Cristian Petru Mihai, Cosmin Teodor Spoială, Elena-Lia Stârcea, Iuliana Magdalena Iliescu-Halitchi, Codruta Olimpiada Zetu, Irina Nicoleta Ionescu, Lavinia Bodescu-Amancei Bogos, Roxana Alexandra Hanganu, Elena Boiculese, Vasile Lucian Healthcare (Basel) Article Acute kidney injury (AKI) occurs frequently in critically ill children, having an incidence of up to 26.9% and is associated with high morbidity and mortality in pediatric intensive care units (PICU). Currently, the decrease in the glomerular filtration rate is calculated using the serum creatinine levels. Nevertheless, there may be a 48 h delay between the renal injury and measurable increase in creatinine. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been validated in relation to cardiopulmonary bypass in children, being able to detect AKI before the functional change proven by the rise in serum creatinine. Our aim was to study the utility of using uNGAL in the management of critical pediatric patients admitted to our hospital in a six month period, more specifically, its capacity to predict AKI development, alone and in the association with the renal angina index (RAI). Twenty-eight critically ill children aged from 1 day to 15 years have been included. We found that an increase in uNGAL in day 1 of admission in the PICU was significantly correlated with a decrease in creatinine clearance but not anymore in day 3. However, in our sample uNGAL did not show a significant predictability for AKI development nor the supplementary incorporation of RAI into the prediction model. Therefore, apart from cardiac surgery, the efficacy and utility or uNGAL in the management of critically ill children is still questionable. For the best prediction, we will need to incorporate not only the RAI or other PICU scores, but other biomarkers such as KIM-1, urinary cystatin, and IL 18 in larger samples. MDPI 2022-08-19 /pmc/articles/PMC9407884/ /pubmed/36011231 http://dx.doi.org/10.3390/healthcare10081575 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gavrilovici, Cristina
Duşa, Cristian Petru
Mihai, Cosmin Teodor
Spoială, Elena-Lia
Stârcea, Iuliana Magdalena
Iliescu-Halitchi, Codruta Olimpiada
Zetu, Irina Nicoleta
Ionescu, Lavinia Bodescu-Amancei
Bogos, Roxana Alexandra
Hanganu, Elena
Boiculese, Vasile Lucian
uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
title uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
title_full uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
title_fullStr uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
title_full_unstemmed uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
title_short uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
title_sort ungal predictive value for serum creatinine decrease in critically ill children
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9407884/
https://www.ncbi.nlm.nih.gov/pubmed/36011231
http://dx.doi.org/10.3390/healthcare10081575
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