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Vuong KT, Joseph C, Angelo JR. Review of acute kidney injury and progression to chronic kidney disease in pediatric patients undergoing hematopoietic cell transplant. Front Oncol 2023; 13:1161709. [PMID: 37287918 PMCID: PMC10242001 DOI: 10.3389/fonc.2023.1161709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/28/2023] [Indexed: 06/09/2023] Open
Abstract
While acute kidney injury (AKI) after hematopoietic cell transplant (HCT) has been well-described in pediatric patients, literature regarding the long term renal consequences of HCT-related AKI, the development of chronic kidney disease (CKD), and CKD care in pediatric patients post-HCT is limited. CKD affects almost 50% of patients after HCT with multifactorial etiology including infection, nephrotoxic medications, transplant-associated thrombotic microangiopathy, graft-versus-host disease, and sinusoidal obstruction syndrome. As renal function declines in CKD, eventually progressing to end stage kidney disease (ESKD), mortality increases and is more than 80% among patients requiring dialysis. Using society guidelines and current literature, this review summarizes definitions and etiologies of and management strategies among patients with AKI and CKD post-HCT with an emphasis on albuminuria, hypertension, nutrition, metabolic acidosis, anemia, and mineral bone disease. The goal of this review is to aid early identification and intervention in patients with renal dysfunction prior to development of ESKD, and to discuss ESKD and renal transplant in these patients post-HCT.
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Cai T, Karlaftis V, Hearps S, Matthews S, Burgess J, Monagle P, Ignjatovic V. Reference intervals for serum cystatin C in neonates and children 30 days to 18 years old. Pediatr Nephrol 2020; 35:1959-1966. [PMID: 32447504 DOI: 10.1007/s00467-020-04612-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/16/2020] [Accepted: 05/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Serum cystatin C (CysC) is a promising biomarker of kidney function, which has higher accuracy and sensitivity when compared with creatinine. To better utilize serum CysC in clinical practice, this study aimed to establish continuous paediatric reference intervals (RIs) for serum CysC. METHODS The study subjects consisted of healthy term neonates and children aged 30 days to 18 years. Venous blood samples were collected and serum CysC levels were measured using the immunoturbidimetric measurement principle. Fractional polynomial regression model and quantile regression was applied in the statistical analysis to generate continuous RIs. RESULTS A total of 378 samples with equal numbers of males and females were analysed for serum CysC. No outliers were found in this analysis. The continuous RIs are presented as equations and graphical scatterplots. CONCLUSIONS This study established continuous paediatric reference intervals (RIs) for serum CysC in healthy term neonates and children. The continuous RIs generated from this study show age-based dynamic changes as well as blood group and gender-specific differences for serum CysC. Graphical abstract.
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Affiliation(s)
- Tengyi Cai
- Murdoch Children's Research Institute, Parkville, Australia
| | | | - Stephen Hearps
- Murdoch Children's Research Institute, Parkville, Australia
| | | | | | - Paul Monagle
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia.,The Royal Children's Hospital, Parkville, Australia
| | - Vera Ignjatovic
- Murdoch Children's Research Institute, Parkville, Australia. .,Department of Paediatrics, The University of Melbourne, Parkville, Australia.
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den Bakker E, Gemke RJ, van Wijk JA, Hubeek I, Stoffel-Wagner B, Bökenkamp A. Evidence for shrunken pore syndrome in children. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 80:32-38. [DOI: 10.1080/00365513.2019.1692231] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Emil den Bakker
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Reinoud Jbj Gemke
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Joanna Ae van Wijk
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Isabelle Hubeek
- Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Birgit Stoffel-Wagner
- Department of Clinical Chemistry and Clinical Pharmacology, University Clinics, Bonn, Germany
| | - Arend Bökenkamp
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Jarquin Campos A, Risch L, Baumann M, Purde MT, Neuber S, Renz H, Mosimann B, Raio L, Mohaupt M, Surbek D, Risch M. Shrunken pore syndrome, preeclampsia, and markers of NO metabolism in pregnant women during the first trimester. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:91-98. [DOI: 10.1080/00365513.2019.1568150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Araceli Jarquin Campos
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Labormedizinisches Zentrum Dr. Risch, Vaduz, Liechtenstein
| | - Lorenz Risch
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Labormedizinisches Zentrum Dr. Risch, Vaduz, Liechtenstein
- University Institut of Clinical Chemistry, University of Bern, Bern, Switzerland
| | - Marc Baumann
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | | | | | - Harald Renz
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
| | - Beatrice Mosimann
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | - Luigi Raio
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | - Markus Mohaupt
- Klinik und Poliklinik für Innere Medizin, Bern, Switzerland
- School of Medicine, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
| | - Daniel Surbek
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | - Martin Risch
- Kantonsspital Graubünden, Zentrallabor, Chur, Switzerland
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den Bakker E, Gemke RJBJ, Bökenkamp A. Endogenous markers for kidney function in children: a review. Crit Rev Clin Lab Sci 2018; 55:163-183. [DOI: 10.1080/10408363.2018.1427041] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Emil den Bakker
- Department of Pediatric Nephrology, VU Medical Centre, Amsterdam, The Netherlands
| | | | - Arend Bökenkamp
- Department of Pediatric Nephrology, VU Medical Centre, Amsterdam, The Netherlands
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Risch M, Purde MT, Baumann M, Mohaupt M, Mosimann B, Renz H, Raio L, Surbek D, Risch L. High first-trimester maternal blood cystatin C levels despite normal serum creatinine predict pre-eclampsia in singleton pregnancies. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:634-643. [PMID: 29069989 DOI: 10.1080/00365513.2017.1393692] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Early biochemical identification of women at high risk for the development of pre-eclampsia (PE) is still unsatisfactory. Renal markers measured during the first trimester were analysed to predict later occurrence of PE. A nested case-control study was conducted within the prospective predictive markers for the diagnosis of preeclampsia study. Pregnant women were included at the end of the first trimester and followed up until birth. Controls were matched to PE cases. Renal markers [i.e. creatinine, cystatin C (CysC), β2 microglobulin (B2M), β-trace protein (BTP), glomerular filtration rate estimations (eGFR) of the aforementioned markers, uric acid (UA), urea, and serum uromodulin (sUMOD)] were compared to placental growth factor (PlGF), a marker known to predict PE later in pregnancy. Reference intervals were determined for the different markers. In the 183 women (PE, n = 39; controls, n = 144), CysC, the CysC/PlGF ratio (p < .01) and UA were higher, whereas the eGFRCysC/eGFRCrea ratio (a marker of glomerular endothelial integrity and shrunken pore syndrome) and PlGF were lower in women who developed PE (p < .05 for all). Compromised filtration of the larger molecule CysC together with a normal creatinine, in a subset of PE cases (15.3%) was a unique, strong and independent predictor of later PE if the baseline CysC concentration was >0.85 mg/l. In conclusion, CysC and its derivatives as well as UA, indicating volume expansion, measured at the end of the first trimester are predictive of PE. Thus, women can be easily identified and followed as an early reduction in glomerular filtration quality poses a high risk for a subsequent development of PE.
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Affiliation(s)
- Martin Risch
- a Zentrallabor , Kantonsspital Graubünden , Chur , Switzerland
| | - Mette-Triin Purde
- b Labormedizinisches Zentrum Dr. Risch , Department of Clinical Chemistry , Vaduz , Liechtenstein
| | - Marc Baumann
- c Department of Obstetrics and Gynecology , Inselspital, University of Bern , Bern , Switzerland
| | - Markus Mohaupt
- d Department of Internal Medicine , Sonnenhofspital , Bern , Switzerland
| | - Beatrice Mosimann
- c Department of Obstetrics and Gynecology , Inselspital, University of Bern , Bern , Switzerland
| | - Harald Renz
- e Institute of Laboratory Medicine , Philipps University Marburg , Marburg , Germany
| | - Luigi Raio
- c Department of Obstetrics and Gynecology , Inselspital, University of Bern , Bern , Switzerland
| | - Daniel Surbek
- c Department of Obstetrics and Gynecology , Inselspital, University of Bern , Bern , Switzerland
| | - Lorenz Risch
- b Labormedizinisches Zentrum Dr. Risch , Department of Clinical Chemistry , Vaduz , Liechtenstein.,f Center of Laboratory Medicine , University Institut of Clinical Chemistry, University of Bern , Bern , Switzerland
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Risch M, Risch L, Purde MT, Renz H, Ambühl P, Szucs T, Tomonaga Y. Association of the cystatin C/creatinine ratio with the renally cleared hormones parathyroid hormone (PTH) and brain natriuretic peptide (BNP) in primary care patients: a cross-sectional study. Scandinavian Journal of Clinical and Laboratory Investigation 2016; 76:379-85. [DOI: 10.1080/00365513.2016.1183262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Martin Risch
- Kantonsspital Graubünden, Zentrallabor, Chur, Switzerland
- Labormedizinisches Zentrum Dr. Risch, Liebefeld, Switzerland
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr. Risch, Liebefeld, Switzerland
- Faculty of Medical Sciences, Private University, Triesen, Liechtenstein
- University Institute of Clinical Chemistry, University Hospital and University of Bern, Bern, Switzerland
| | - Mette-Triin Purde
- Faculty of Science, Tallinn University of Technology, Tallinn, Estonia
| | - Harald Renz
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
| | - Patrice Ambühl
- Division of Nephrology, Stadtspital Waid, Zurich, Switzerland
| | - Thomas Szucs
- European Center of Pharmaceutical Medicine, University of Basel, Basel, Switzerland
| | - Yuki Tomonaga
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Abstract
PURPOSE OF REVIEW This article answers the question of whether creatinine is the best biomarker for monitoring neonatal glomerular filtration rate (GFR) in view of recent advances in measuring neonatal renal function. RECENT FINDINGS We rely largely on serum creatinine for the estimation of GFR in the newborn, even though creatinine is freely exchanged through the placenta. During the first few days of life, the serum creatinine reflects maternal renal function or the maternal creatinine. Back filtration of creatinine in preterm newborns is also a serious limitation. This review summarizes current knowledge on the prenatal and postnatal handling of creatinine as well as that of other, more novel biomarkers of GFR, such as cystatin C (CysC) and β-trace protein (BTP). Only small amounts of CysC cross the placenta, whereas BTP does not cross the placenta at all. However, BTP measurements are not widely available. Recent studies on renal volumetry are also discussed. SUMMARY Currently, CysC may be the most suitable marker of neonatal renal function, but its availability is still limited, it is more costly, and the best method of reporting acute kidney injury and neonatal estimated GFR remains to be established.
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Zwiers AJM, Cransberg K, de Rijke YB, Willemsen SP, de Mol AC, Tibboel D, de Wildt SN. Reference ranges for serum β-trace protein in neonates and children younger than 1 year of age. Clin Chem Lab Med 2015; 52:1815-21. [PMID: 24940717 DOI: 10.1515/cclm-2014-0371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 05/26/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND β-Trace protein (BTP) has been proposed as an alternative endogenous marker of glomerular filtration rate. Data on BTP reference ranges in young children are scarce. We therefore aim to establish reference ranges and examine the developmental course of serum BTP in basically healthy children younger than 1 year of age. METHODS Single blood samples were taken from healthy children (born at gestational age ≥37 weeks) <12 months of age. Serum BTP was measured using the N latex B-trace protein assay (Siemens Diagnostics, Deerfield, IL, USA) on an Immage® 800 Rate Nephelometer (Beckman Coulter Inc. Brea, CA, USA). Serum creatinine and cystatin C were additionally determined and compared to reference values to confirm a normal renal function. RESULTS From June 2010 to January 2014, 95 blood samples were collected from 95 children {67.4% male; median age 120 days [inter quartile range 57-166]}. BTP was normally distributed (mean concentration 0.84±standard deviation 0.35 mg/L). Considering all children, the 50th centile BTP reference concentration was 0.82 mg/L (5th-95th centiles; 0.27-1.38). BTP concentrations were the highest in neonates and steadily declined with increasing age (Spearman's rank correlation was -0.415, p=0.002). No gender differences were found. CONCLUSIONS Our data provide a BTP reference range for the first year of life. Seeing the biological pattern of BTP, with only a limited postnatal decline, this marker might offer a promising alternative to serum creatinine-based methods for estimating glomerular filtration rate in newborns.
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Filler G, Kusserow C, Lopes L, Kobrzyński M. Beta-trace protein as a marker of GFR--history, indications, and future research. Clin Biochem 2014; 47:1188-94. [PMID: 24833359 DOI: 10.1016/j.clinbiochem.2014.04.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 04/29/2014] [Accepted: 04/30/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Recent findings suggest that beta-trace protein (BTP), a small molecular weight protein, is at least equal if not superior to serum creatinine as a marker of glomerular filtration rate (GFR), particularly since it is independent from height, gender, age, and muscle mass. The authors sought to summarize knowledge on BTP and its use as a marker of GFR using the most recent literature available. DESIGN AND METHODS The authors compiled key articles and all relevant recent literature on this topic. Physical and chemical features of the molecule are described, as well as factors that may affect its expression. The use of BTP in estimating GFR as a whole and in specific patient groups, including pregnant women, neonates and infants, children and adolescents, and patients who have undergone renal transplantation is discussed. The use of BTP as a marker for cardiovascular risk factors is also briefly addressed. RESULTS Although its performance in the general population is marginally inferior to cystatin C, studies have suggested that it may be superior in accurately estimating GFR in select patient groups such as pregnant women and neonates. CONCLUSIONS This novel marker shows promise, but further research is required to clarify findings from available data.
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Affiliation(s)
- Guido Filler
- Department of Paediatrics, Schulich School of Medicine & Dentistry, London, ON N6A 5W9, Canada; Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N5A 5A5, Canada; Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N5A 5A5, Canada.
| | - Carola Kusserow
- Department of Paediatrics, Schulich School of Medicine & Dentistry, London, ON N6A 5W9, Canada
| | - Laudelino Lopes
- Department of Obstetrics & Gynaecology, Schulich School of Medicine & Dentistry, London, ON N6A 5W9, Canada
| | - Marta Kobrzyński
- Department of Paediatrics, Schulich School of Medicine & Dentistry, London, ON N6A 5W9, Canada
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Reference values of serum cystatin-C for full-term and preterm neonates in Istanbul. Indian J Pediatr 2012; 79:1037-42. [PMID: 22180301 DOI: 10.1007/s12098-011-0655-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 12/01/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To determine the level and distribution of Cystatin C values in full-term and preterm healthy neonates for the purpose of diagnosis and follow-up of renal diseases of the neonates. METHODS Eighty-eight newborn infants, including 55 preterm and 33 term born in the authors' hospital having no urinary tract pathology, symptoms or signs during prenatal and postnatal follow-up, were studied . RESULTS There were 25 neonates born between gestational wk of 28 and 32 (Group 1), 30 neonates born between gestational wk of 33-36 (Group 2) and 33 neonates born after gestational wk of 37 (Group 3). Average cystatin C values were determined to be 1.41 mg/l, 1.22 mg/l and 1.21 mg/l for Group 1, Group 2 and Group 3, respectively. CONCLUSIONS Evaluation of cystatin C can be effective for follow-up of renal pathologies, because it is not affected by gender, body weight and muscle mass and has a constant production rate.
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Novakov Mikic A, Cabarkapa V, Nikolic A, Maric D, Brkic S, Mitic G, Ristic M, Stosic Z. Cystatin C in pre-eclampsia. J Matern Fetal Neonatal Med 2012; 25:961-5. [DOI: 10.3109/14767058.2011.601366] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Preliminary reference intervals for cystatin C and beta-trace protein in preterm and term neonates. Clin Biochem 2011; 44:1156-1159. [PMID: 21771588 DOI: 10.1016/j.clinbiochem.2011.06.987] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 06/24/2011] [Accepted: 06/29/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine the reference intervals for serum cystatin C (CysC) and beta-trace protein (BTP) as markers of renal function in preterm and term neonates. DESIGN AND METHODS Blood samples of 128 neonates (34% female) admitted to the NICU were analyzed to determine the levels of serum creatinine (enzymatically), CysC and BTP (nephelometric, Siemens Health Care). RESULTS The reference intervals, categorized by age, were reported for the 128 neonates. Median (lower/upper limit) BTP were 1.85 (0.57/3.16) and 1.27 (0.51/2.07) mg/L on days 1 and 3. In keeping with maturation of renal function after birth, CysC and BTP fell from days one to day three after birth, whereas creatinine did not. CONCLUSION Our data provides reference intervals for the levels of creatinine, CysC, and BTP in neonates on days 1 and 3 after birth and demonstrates that CysC and BTP reflect neonatal renal function, whereas creatinine reflects maternal renal function.
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Author response to: Reference values for clinical chemistry tests during normal pregnancy. BJOG 2008. [DOI: 10.1111/j.1471-0528.2008.01917.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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