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Clinical relevance of plasma cystatin C in the diagnosis of acute kidney injury in preterm infants
- Authors: Volkova A.A.1, Kozlova E.M.1, Novopoltseva E.G.1, Shunkina G.L.2, Kolchina A.N.1, Rakhmanova N.A.3, Shmeleva A.O.1
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Affiliations:
- Privolzhsky Research Medical University
- Nizhny Novgorod Regional Children’s Clinical Hospital
- City Hospital No. 40
- Issue: Vol 15, No 2 (2024)
- Pages: 23-30
- Section: Original studies
- URL: https://journals.eco-vector.com/pediatr/article/view/636236
- DOI: https://doi.org/10.17816/PED15223-30
- ID: 636236
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Abstract
BACKGROUND: Acute kidney injury is one of the most common syndromes in premature neonates requiring treatment in intensive care units. Early diagnosis of acute kidney injury in these patients is extremely difficult due to lack of specific signs, morphofunctional immaturity, low sensitivity and specificity of renal dysfunction markers.
AIM: The aim of the study is to assess the clinical significance of plasma cystatin C concentration in the diagnosis of acute kidney injury in premature newborns in the early neonatal period.
MATERIALS AND METHODS: The design was a primary, prospective, non-randomised study including 100 preterm neonates with gestational age less than 37 weeks and birth weight up to 1500 g. Indicators of renal functional status (creatinine, diuresis rate, cystatin C) were assessed on the first, third and seventh days of life.
RESULTS: Low birth weight (p = 0.001; OR = 0.226), the need for invasive control mechanical ventilation (p = 0.012; OR = 6.32) and inotropic therapy (p = 0.025; OR = 4.99) are associated with a high risk of acute kidney injury development. A direct correlation was found between the presence of acute kidney injury, plasma creatinine (p = 0.001, r = 0.688) and cystatin C (p = 0.001, r = 0.689) levels. The first increase in plasma creatinine levels relative to basal levels in preterm neonates with acute kidney injury was noted from the third day of life, which was statistically significant compared to those of children without acute kidney injury (91.0 vs 57.0 mmol/l; p < 0.001). The concentration of cystatin C in patients with acute kidney injury is increased from the first day of life (1.85 vs 1.57 ng/ml) and continues to steadily increase by the seventh day of life (2.27 vs 1.84 ng/ml; p < 0.001).
CONCLUSIONS: Increased concentration of cystatin C in preterm neonates with acute kidney injury is observed from the first day of life and increases in dynamics, which allows us to consider it a highly sensitive and significant marker of renal dysfunction in the early neonatal period.
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About the authors
Anastasia A. Volkova
Privolzhsky Research Medical University
Author for correspondence.
Email: chagan89@yandex.ru
ORCID iD: 0000-0003-0560-616X
SPIN-code: 8040-3716
Assistant of the Department of Faculty and Polyclinic Paediatrics
Russian Federation, 10/1 Minina and Pozharskogo sq., 603005, Nizhny Novgorod
Elena M. Kozlova
Privolzhsky Research Medical University
Email: pediatrnn@list.ru
ORCID iD: 0000-0002-1173-2130
SPIN-code: 9784-8965
MD, Dr. Sci. (Medicine), Professor of the Department of Faculty and Polyclinic Paediatrics
Russian Federation, 10/1 Minina and Pozharskogo sq., 603005, Nizhny NovgorodEkaterina G. Novopoltseva
Privolzhsky Research Medical University
Email: eknovopol@mail.ru
ORCID iD: 0000-0001-8492-1509
SPIN-code: 9551-6784
Dr. Sci. (Medicine), Professor, head of Department of Faculty and Polyclinic Paediatrics
Russian Federation, 10/1 Minina and Pozharskogo sq., 603005, Nizhny NovgorodGalina L. Shunkina
Nizhny Novgorod Regional Children’s Clinical Hospital
Email: galina1363@mail.ru
ORCID iD: 0000-0002-5916-1840
PhD, Cand. Sci. (Biology), Head of the Clinical and Diagnostic Laboratory
Russian Federation, Nizhny NovgorodAnastasia N. Kolchina
Privolzhsky Research Medical University
Email: kolchina.a@mail.ru
ORCID iD: 0000-0001-9290-3060
SPIN-code: 1949-8595
MD, PhD, Cand. Sci. (Medicine), Assistant of the Department of Hospital Paediatrics
Russian Federation, Nizhny NovgorodNadezhda A. Rakhmanova
City Hospital No. 40
Email: trype@mail.ru
ORCID iD: 0009-0006-8243-1665
MD, Anaesthesiologist and Resuscitator of the Neonatal Intensive Care Unit
Russian Federation, Nizhny NovgorodAnastasia O. Shmeleva
Privolzhsky Research Medical University
Email: nastyabynthyth78@gmail.com
ORCID iD: 0009-0009-0611-0933
MD, Resident of the F.D. Agafonov Department of Paediatrics
Russian Federation, Nizhny NovgorodReferences
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