Serum KIM-1 and Cystatin Levels as the Predictors of Acute Kidney Injury in Asphyxiated Neonates

Document Type : Original Article

Authors

1 Department of Pediatrics, School of Medicine, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Pediatrics, School of Medicine, Al Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Pediatrics, School of Medicine, Kidney Diseases Research Center, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran

5 Department of Social Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Asphyxia may lead to serious complications, among which acute kidney injury (AKI) is the most common. Early diagnosis of AKI can help prevent impaired acid-base, fluid, and electrolyte balance that may lead to life-threatening complications. This study aimed to evaluate the effect of kidney injury molecule-1 (KIM-1) and cystatin-C in the early diagnosis of AKI among asphyxiated neonates.
Methods: This case-control study was conducted on 45 asphyxiated neonates, 24 of whom were in the control group and 23 cases were in the case group. Creatinine (Cr), KIM-1, and cystatin-C were measured for participants within 8 h and 4 days after birth and compared between case and control groups.
Results: The mean level of Cr-Standardized KIM-1 measured within 8 h and 4 days after birth was significantly higher in the case group, compared to the control group (P-value<0.05). The mean level of Cr-Standardized cysteine, only 4 days after birth, was significantly higher in the case group, compared to the control group (P-value<0.05). A receiver operating characteristic (ROC) curve analysis demonstrated that between the two biomarkers with two measurements, the KIM-1 Cr-Standardized within 4 days had the highest area under the curve (AUC) (0.751, 95% CI: 0.597-0.905). Moreover, the results of ROC curve analysis showed that Cr-Standardized KIM-1 within 4 days after birth with a critical value of >0.67 ng/ml allowed to predict kidney failure in newborns with 57.1‌% sensitivity and 86.4‌% specificity.
Conclusion: The findings of the present study show that high-specificity KIM-1 is a good biomarker for the early detection of acute renal failure in asphyxiated infants; however, similar expectations cannot exist with regards to cystatin-C for at least the first 8 h after birth.
 
 

Keywords

References

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Iranian Journal of Neonatology
Volume 13, Issue 1
January 2022
Pages 6-12

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