The outcome of acute kidney injury substages based on urinary cystatin C in critically ill children

• Published in: Annals of intensive care 2023-03, Vol.13 (1), p.23-23, Article 23
• Main Authors: Chen, Jiao, Jiang, Zhen, Huang, Hui, Li, Min, Bai, Zhenjiang, Kuai, Yuxian, Wei, Lin, Liu, Ning, Li, Xiaozhong, Lu, Guoping, Li, Yanhong
• Format: Article
• Language: English
• Subjects: Acute kidney injury; Anesthesiology; Critical Care Medicine; Critically ill children; Emergency Medicine; Intensive; Intensive care; Kidneys; Medicine; Medicine & Public Health; Mortality; Pediatrics; Subclinical acute kidney injury; Urinary CysC
• ISSN: 2110-5820; 2110-5820
• DOI: 10.1186/s13613-023-01119-8

Background The concept of acute kidney injury (AKI) substages has been recommended to better phenotype AKI and identify high-risk patient groups and therefore improve the diagnostic accuracy of AKI. However, there remains a gap between the recommendation and the clinical application. The study aimed to explore the incidence of AKI substages based on a sensitive AKI biomarker of urinary cystatin C (uCysC), and to determine whether AKI substages were relevant with respect to outcome in critically ill children. Results The multicenter cohort study enrolled 793 children in pediatric intensive care unit (PICU) of four tertiary hospitals in China. Children were classified as non-AKI, sub-AKI and AKI substages A and B according to uCysC level at PICU admission. Sub-AKI was defined by admission uCysC level ≥ 1.26 mg/g uCr in children not meeting the KDIGO criteria of AKI. In children who fulfilled KDIGO criteria, those with uCysC