Acute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels
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Date
2020
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College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khod, Muscat, Oman
Abstract
Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may
not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the
prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast
to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at
the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe
malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric
assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin
C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine
values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO)
criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine
levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and
absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence
of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher
using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001,
respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual
burden of disease in children with severe malaria.
Description
Keywords
Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria
Citation
Afolayan, F. M., Adedoyin, O. T., Abdulkadir, M. B., Ibrahim, O. R., Biliaminu, S. A., Mokuolu, O. A., & Ojuawo, A. (2020). Acute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels. Sultan Qaboos University Medical Journal, 20(4), e312-e317