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Serum Cystatin‐ C as a Marker of Acute Kidney Injury in the Newborn After Perinatal Hypoxia/Asphyxia
Author(s) -
Treiber Milena,
Gorenjak Maksimiljan,
Pecovnik Balon Breda
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12054
Subject(s) - medicine , asphyxia , cystatin c , acute kidney injury , hypoxia (environmental) , perinatal asphyxia , renal function , obstetrics , oxygen , chemistry , organic chemistry
We evaluated cystatin‐ C (cys C ) in the umbilical blood as a predictor of acute kidney injury ( AKI ) after perinatal hypoxia/asphyxia compared with creatinine ( Cr ). One hundred full‐term newborns were enrolled in the study (50 in a group affected by perinatal hypoxia/asphyxia [ AS] and 50 controls). CysC and Cr were measured in blood samples from the umbilical cord at birth ( cysC ‐umb and C r‐umb) and from a peripheral vein 3 days later ( cysC ‐3 and Cr ‐3). At birth, the mean level of cysC in healthy term babies was found to be 1.39 ± 0.19 mg/L and 1.34 ± 0.21 mg/L after 3 days of life, not significantly decreased ( P = 0.137). The mean of cysC in the AS group was 2.12 ± 0.53 mg/ L in cord blood and 1.56 ± 0.32 g/L in day 3 blood samples, also decreased ( P < 0.001) and different from the control ( P < 0.001). Cr levels, determined simultaneously at birth were different ( P = 0.001) between the control (62.74 ± 12.84 μmol/ L ) and AS (72.60 ± 15.55 μmol/ L ) group, significantly decreased after 3 days in both groups ( P < 0.001). The receiver‐operating characteristic curve analysis, comparing AS and the control group, showed area under the curve for cysC ‐umb, cysC ‐3, C r‐umb and Cr ‐3 (0.918; 0.698; 0.692; 0.660). The highest diagnostic accuracy was achieved with a chosen cut‐off for cysC ‐umb of 1.67 mg/ L (sensitivity of 84.0%, specificity of 90.0%) or 1.69 mg/ L (sensitivity of 82.0%, specificity of 94.0%). Our results indicate serum CysC is a more sensitive marker of glomerular filtration rate than C r in the newborns.