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The Prognostic Value of Inflammatory Markers in Paediatric Acute Kidney Injury
Flavia Chisavu1,2, Lazar Chisavu2,3,4, Mihai Gafencu1,5
14th Pediatric Clinic, "Louis Turcanu" Children's Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timisoara, Romania.
Insights
Pediatric acute kidney injury (AKI) is predicted by inflammatory markers like ferritin, C-reactive protein, and procalcitonin. While these markers indicate AKI risk, they do not independently affect mortality in children.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Biomarkers
Background:
- Acute kidney injury (AKI) is a significant concern in pediatric populations.
- The predictive value of inflammatory markers for AKI in children remains under investigation.
Purpose of the Study:
- To assess the utility of various inflammatory markers in predicting AKI and mortality in pediatric patients.
- To determine if procalcitonin, CRP, ferritin, and other markers can forecast AKI development and outcomes in children.
Main Methods:
- An observational retrospective cohort study was conducted.
- Data from 131 children admitted to a Romanian emergency hospital were analyzed.
- Evaluated inflammatory markers included procalcitonin, CRP, LDH, ferritin, IL-6, albumin, and ESR.
Main Results:
- The incidence of AKI was 39.6%, with a high proportion of these patients in the ICU.
- Patients with AKI exhibited elevated levels of ferritin, CRP, and procalcitonin.
- Ferritin, CRP, and procalcitonin were identified as predictors of AKI development.
Conclusions:
- Ferritin, C-reactive protein, and procalcitonin are valuable predictors for identifying pediatric AKI.
- None of the assessed inflammatory markers demonstrated an independent influence on mortality.
- AKI itself remains a critical independent risk factor for mortality in children across various conditions.
Abstract:
Background/Objectives: Acute kidney injury (AKI) is common in children. Several inflammatory markers proved their utility in predicting AKI, especially in adults, but their utility in children's populations is still under debate. Methods: We performed an observational retrospective cohort study on children admitted to the "Louis Turcanu" Emergency County Hospital for Children from Timisoara, Romania. We evaluated the utility of procalcitonin, C reactive protein, lactate dehydrogenase, ferritin, interleukin 6, albumins and erythrocyte sedimentation rate in predicting AKI and mortality in children. Results: The final cohort consisted of 131 children. The incidence of AKI was 39.6%, with more than half (61.1%) admitted in the intensive care unit. Out of twelve deaths, 11 were encountered in the AKI group. Patients from the AKI group presented higher levels of several inflammatory markers: lactate dehydrogenase, C reactive protein, procalcitonin, LDH, CRP, PCT and ferritin and lower albumins. Only ferritin, C reactive protein and procalcitonin could predict AKI development. Procalcitonin seems to increase mortality, but in the adjusted regression model, only AKI increased mortality. AKI increased mortality by 4.11 times (95%CI = 1.07-15.66, p = 0.038). Conclusions: Procalcitonin, C reactive protein, and ferritin proved to be predictors of AKI, yet none of the inflammatory markers influenced mortality. AKI is still an important independent mortality factor regardless of the underlying disease spectrum.
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