Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Pediatr Res. 2022 Aug;92(2):541-548. doi: 10.1038/s41390-021-01813-y. Epub 2021 Nov 1.
To determine the associations of urinary CXC motif chemokine 10 (uCXCL10) with AKI, sepsis and pediatric intensive care unit (PICU) mortality in critically ill children, as well as its predictive value for the aforementioned issues.
Urinary CXCL10 levels were serially measured in 342 critically ill children during the first week after PICU admission. AKI diagnosis was based on the criteria of KDIGO. Sepsis was diagnosed according to the surviving sepsis campaign's international guidelines for children.
Fifty-two (15.2%) children developed AKI, 132 (38.6%) were diagnosed with sepsis, and 30 (12.3%) died during the PICU stay. Both the initial and peak values of uCXCL10 remained independently associated with AKI, sepsis, septic AKI and PICU mortality. The AUCs of the initial uCXCL10 for predicting AKI, sepsis, septic AKI and PICU mortality were 0.63 (0.53-0.72), 0.62 (0.56-0.68), 0.75 (0.64-0.87) and 0.77 (0.68-0.86), respectively. The AUCs for prediction by using peak uCXCL10 were as follows: AKI 0.65 (0.56-0.75), sepsis 0.63 (0.57-0.69), septic AKI 0.76 (0.65-0.87) and PICU mortality 0.84 (0.76-0.91).
Urinary CXCL10 is independently associated with AKI and sepsis and may be a potential indicator of septic AKI and PICU mortality in critically ill children.
Urinary CXC motif chemokine 10 (uCXCL10), as an inflammatory mediator, has been proposed to be a biomarker for AKI in a specific setting. AKI biomarkers are often susceptible to confounding factors, limiting their utility as a specific biomarker, especially in heterogeneous population. This study revealed that uCXCL10 levels are independently associated with increased risk for AKI, sepsis, septic AKI and PICU mortality. A higher uCXCL10 may be predictive of septic AKI and PICU mortality in critically ill children.
为了确定尿趋化因子（CXC 基序）配体 10（uCXCL10）与危重病患儿急性肾损伤（AKI）、脓毒症和儿科重症监护病房（PICU）死亡率的关系，以及其对上述问题的预测价值。
在 PICU 入院后第一周内，对 342 名危重病患儿连续测量尿 CXCL10 水平。AKI 的诊断基于 KDIGO 的标准。脓毒症根据拯救脓毒症运动（SSC）的儿童国际指南进行诊断。
52 名（15.2%）患儿发生 AKI，132 名（38.6%）患儿诊断为脓毒症，30 名（12.3%）患儿在 PICU 期间死亡。初始和峰值 uCXCL10 值均与 AKI、脓毒症、脓毒症相关 AKI 和 PICU 死亡率独立相关。初始 uCXCL10 预测 AKI、脓毒症、脓毒症相关 AKI 和 PICU 死亡率的 AUC 分别为 0.63（0.53-0.72）、0.62（0.56-0.68）、0.75（0.64-0.87）和 0.77（0.68-0.86）。使用峰值 uCXCL10 预测的 AUC 如下：AKI 为 0.65（0.56-0.75），脓毒症为 0.63（0.57-0.69），脓毒症相关 AKI 为 0.76（0.65-0.87），PICU 死亡率为 0.84（0.76-0.91）。
尿 CXCL10 与 AKI 和脓毒症独立相关，可能是危重病患儿脓毒症相关 AKI 和 PICU 死亡率的潜在指标。
作为一种炎症介质，尿趋化因子（CXC 基序）配体 10（uCXCL10）已被提出可作为特定情况下 AKI 的生物标志物。AKI 生物标志物通常易受混杂因素的影响，限制了其作为特定生物标志物的应用，尤其是在异质人群中。本研究表明，uCXCL10 水平与 AKI、脓毒症、脓毒症相关 AKI 和 PICU 死亡率增加的风险独立相关。较高的 uCXCL10 可能预示着危重病患儿的脓毒症相关 AKI 和 PICU 死亡率。
