Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
Department of Neonatology, Royal North Shore Hospital, St Leonards, Australia.
Clin Chem Lab Med. 2020 Aug 6;59(2):373-382. doi: 10.1515/cclm-2020-0781.
The use of kidney function and injury markers for early detection of drug-related glomerular or tubular kidney injury in infants, children and adolescents requires age-specific data on reference intervals in a pediatric healthy population. This study characterizes serum values for eight kidney function and injury markers in healthy infants, children and adolescents.
A single center prospective observational study was conducted between December 2018 and June 2019. Serum samples from 142 healthy infants, children and adolescents aged between 0 and ≤15 years were collected. Statistical analyses for eight markers (albumin (ALB), β2-microglobulin (B2M), β-trace protein (BTP), creatinine (SCR), cystatin C (CYSC), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), uromodulin (URO)) were performed to obtain reference intervals and associations with age, sex and weight were investigated (Pearson correlation, linear and piecewise regression).
ALB and SCR increased with age (p<0.01), whereas B2M, BTP and KIM-1 values decreased with advancing age (p<0.05) in this healthy pediatric study population. CYSC showed dependency on sex (lower concentration in females) and decreased with age until reaching approximately 1.8 years; thereafter an increase with age was seen. NGAL and URO did not show any age-dependency.
This study provides age appropriate reference intervals for key serum kidney function and injury markers determined in healthy infants, children and adolescents. Such reference intervals facilitate the interpretation of changes in kidney function and injury markers in daily practice, and allow early detection of glomerular and tubular injury in infancy, childhood and adolescence.
在婴儿、儿童和青少年中，使用肾功能和损伤标志物来早期检测与药物相关的肾小球或肾小管肾损伤，需要在儿科健康人群中获得特定年龄的参考区间数据。本研究描述了健康婴儿、儿童和青少年中 8 种肾功能和损伤标志物的血清值。
2018 年 12 月至 2019 年 6 月进行了一项单中心前瞻性观察研究。收集了 142 名年龄在 0 至 15 岁之间的健康婴儿、儿童和青少年的血清样本。对 8 种标志物（白蛋白（ALB）、β2-微球蛋白（B2M）、β-痕迹蛋白（BTP）、肌酐（SCR）、胱抑素 C（CYSC）、肾损伤分子-1（KIM-1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、尿调蛋白（URO））进行了统计分析，以获得参考区间，并研究了年龄、性别和体重的相关性（Pearson 相关、线性和分段回归）。
在这个健康的儿科研究人群中，ALB 和 SCR 随年龄增长而增加（p<0.01），而 B2M、BTP 和 KIM-1 值随年龄增长而降低（p<0.05）。CYSC 依赖于性别（女性浓度较低），并随年龄下降至约 1.8 岁；此后，随年龄增加而增加。NGAL 和 URO 没有显示出任何年龄相关性。
本研究为健康婴儿、儿童和青少年中确定的关键血清肾功能和损伤标志物提供了适合年龄的参考区间。这些参考区间有助于在日常实践中解释肾功能和损伤标志物的变化，并允许在婴儿、儿童和青少年期早期检测肾小球和肾小管损伤。
