Department of Pediatrics, Division of Nephrology, Toronto Hospital for Sick Children, Toronto, ON, Canada.
Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
Biomark Med. 2020 Jul;14(10):879-894. doi: 10.2217/bmm-2019-0419. Epub 2020 Aug 18.
NGAL, IL-18, KIM-1 as well as urinary TIMP2 and IGFBP7 and their mathematical product (TIMP2IGFBP7) were evaluated for detecting pediatric aminoglycoside acute kidney injury (AG-AKI). In a prospective study, noncritically ill children received aminoglycosides (AG) ≥3 days. The area under the curve (AUC) for biomarkers to detect AKI was calculated by a) days before AKI onset; b) treatment days. There were 113 AG episodes (68% febrile neutropenia). The AKI group had a higher proportion with febrile neutropenia. The AKI group had significantly lower NGAL 3 days before AKI, as patients with febrile neutropenia had a lower NGAL during AG treatment (p < 0.05). NGAL, IL-18 and TIMP2IGFBP7 had AUC ≥0.73 at 3, 2 and 2 days before AKI onset. NGAL, IL-18 and TIMP2*IGFBP7 were modest early biomarkers of AG-AKI. Febrile neutropenia was associated with lower NGAL.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、白细胞介素 18（IL-18）、肾损伤分子 1（KIM-1）以及尿 TIMP2 和 IGFBP7 及其乘积（TIMP2IGFBP7）被评估用于检测儿科氨基糖苷类急性肾损伤（AG-AKI）。在一项前瞻性研究中，非危重症儿童接受氨基糖苷类药物（AG）治疗≥3 天。通过以下两种方法计算生物标志物检测 AKI 的曲线下面积（AUC）：a）在 AKI 发作前的天数；b）治疗天数。共有 113 例 AG 发作（68%为发热性中性粒细胞减少症）。AKI 组中有更高比例的发热性中性粒细胞减少症。AKI 组在 AKI 发生前 3 天的 NGAL 显著降低，因为发热性中性粒细胞减少症患者在 AG 治疗期间的 NGAL 较低（p<0.05）。在 AKI 发作前 3、2 和 2 天，NGAL、IL-18 和 TIMP2IGFBP7 的 AUC 均≥0.73。NGAL、IL-18 和 TIMP2*IGFBP7 是 AG-AKI 的适度早期生物标志物。发热性中性粒细胞减少症与 NGAL 降低有关。
