EARLY DETECTION OF ACUTE KIDNEY INJURY IN PRETERM NEWBORNS WITH PERINATAL ASPHYXIA USING SERUM CYSTATIN

Emina Hadžimuratovic; Admir Hadžimuratović; Danka Pokrajac; Suada Branković; Vedran Djido

doi:10.5937/sanamed0-42616

Emina Hadžimuratovic University Medical Center Sarajevo, Pediatric Clinic, Department of neonatology, Sarajevo, Bosnia and Herzegovina
Admir Hadžimuratović University Medical Center Sarajevo, Pediatric Clinic, Department of neonatology, Sarajevo, Bosnia and Herzegovina
Danka Pokrajac University Medical Center Sarajevo, Pediatric Clinic, Department of nephrology, Sarajevo, Bosnia and Herzegovina
Suada Branković Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Vedran Djido Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

DOI: https://doi.org/10.5937/sanamed0-42616

Keywords: preterm newborn, perinatal asphyxia, acute kidney injury, biomarkers, cystatin C

Abstract

Introduction:The diagnosis of acute kidney injury (AKI) in preterm newborns with perinatal asphyxia based on increased serum creatinine (sCr) value and oliguria/anuria is usually delayed. The Aim of this paper is to evaluate serum cystatin C as an early predictor of AKI. Materials and methods:The study included 42 preterm newborns (24-37 weeks) with perinatal asphyxia (Apgar score (AS) ≤ 3 at 5 minutes of life or blood pH on admission ≤ 7.00). The sCr and sCys-C levels were measured on the 1st, 3rd, and 7th day of life. According to KDIGO criteria, the newborns were classified into groups, and sCr and sCys-C values were compared.

Results:The mean gestational age was 29.9 ± 3.0 weeks. AKI was diagnosed in 62.8 % of patients. Of these patients, 81.5% belonged to AKI 1 group, and 18.5 % to AKI 2 group.No newborns had the criteria for AKI 3. On day 7 the mean sCr values were significantly higher in AKI (65.4± 21.8) compared with the non-AKI group (168.4±38.2) (p<0.001), but not on day 1 and 3 (p = 0.322, 0.012, respectively). The sCys-C values were significantly higher in the AKI group on day 3 ( AKI vs. non-AKI group, 0.69 ±0.22 vs. 1.22 ±0.20; p <0.001) and day 7 (AKI vs. non-AKI group, 0.62 ±0.41 vs. 1.68 ±0.20; p <0.001). The sCys-C was also an earlier marker of a more severe stage of AKI than sCr.

Conclusion:The sCys-C was elevated earlier than sCr, making it a valuable diagnostic tool for AKI in preterm newborns.

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