Researchers at the University of Liverpool have identified a unique method of identifying the early signs of a potentially serious condition known as Acute Kidney Injury (AKI).
The condition occurs commonly in critically ill children admitted to paediatric intensive care units often because of reduced blood supply to the kidneys (for example due to dehydration or sepsis), heart bypass surgery, or due to medicines which can cause kidney injury. Children who develop AKI have poorer immediate outcomes including longer hospital stay and increased mortality. They also have an increased risk of long-term reduction in kidney function (Chronic Kidney Disease).
Diagnosis of AKI depends on identifying elevation of a substance called creatinine in the blood. However, this only rises slowly after a kidney injury, therefore recognition of AKI is frequently delayed. If doctors can identify children at high risk for AKI early on, then pre-emptive therapy, such as renal replacement therapy (dialysis), could be instituted earlier to protect the kidneys from further injury.
In this study, led by Dr. Rachel McGalliard and Dr. Steve McWilliam, the team looked at the potential of two early markers to predict severe AKI in children admitted to the Paediatric Intensive Care Unit (PICU) at Alder Hey Children’s NHS Foundation Trust. The first, a protein called Neutrophil Gelatinase-Associated Lipocalin (NGAL), measured in urine and blood, and the second is a clinical score called the Renal Angina Index (RAI).
After an extensive study, the team found that a combination of RAI and urinary NGAL on the first day of PICU admission provided an accurate prediction for severe AKI—a potentially life-saving discovery for many critically-ill children.
In the study, 16% of children admitted to PICU developed severe AKI within 72 hours of admission, and 7% required renal replacement therapy. In keeping with previous studies, development of AKI was associated with prolonged PICU admission and increased mortality. A novel finding in this study, was that AKI was also associated with increased risk of hospital-acquired infection.
Dr. McGalliard, an NIHR Academic Clinicainfectionl Fellow in Paediatric Infectious Diseases and first author on the paper, said: “I am most proud of the analysis being in a clinically heterogenous paediatric population. Potentially, these results could lead to earlier identification of acute kidney injury (AKI) in critically ill children and could be used to trial pre-emptive therapy, if validated in further studies.”
Dr. McWilliam, a Senior Lecturer in Paediatric Clinical Pharmacology, said: “The results of this study are extremely exciting. The renal angina index is a simple calculation that could easily be automatically provided in electronic medical records at PICU admission. NGAL assays compatible with most clinical laboratory analysers are now widely available, making its real-time measurement in these critically unwell children realistic. We are now in a great position to investigate whether having these results available in real-time in PICUs could lead to reduced rates of AKI in these children, and whether they can be used to effectively target protective strategies to those at high risk of AKI.”
Combined tests can predict kidney injury risk in critically ill children
Rachel J. McGalliard et al, Identifying critically ill children at high risk of acute kidney injury and renal replacement therapy, PLOS ONE (2020). DOI: 10.1371/journal.pone.0240360
Biomarker combination predicts kidney injury in critically ill children (2020, November 2)
retrieved 2 November 2020
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.
- भगवान बिरसा मुण्डा ने जनजातीय संस्कृति और देश की आजादी के लिए प्राणों की आहुति दी- मुख्यमंत्री श्री चौहान - November 25, 2020
- Why coronavirus rules should be about more than just stopping transmission - November 25, 2020
- AHA News: Teens’ Ultra-Processed Diet Puts Their Hearts at Risk - November 25, 2020
- HETERO Pool Campus Drive for BSc MPharm Freshers Production QC QA Departments on 30th Nov 2020 - November 25, 2020
- सभी पात्र आदिवासी बंधुओं को मिलेंगे काबिज भूमि के पट्टे - November 25, 2020
- Getting drugs to cancer patients - November 25, 2020
- Health Highlights, Nov. 25, 2020 - November 25, 2020
- धर्म स्वातंत्र्य विधेयक-2020 को अंतिम रूप दिया जा रहा है - November 25, 2020
- Health Tips Lose Weight With Eggs By Avoiding These 4 Mistakes - November 25, 2020
- New study explains important cause of fatal influenza - November 25, 2020