ArticleJAMA pediatrics2015
Association of definition of acute kidney injury by cystatin C rise with biomarkers and clinical outcomes in children undergoing cardiac surgery.
Article in JAMA pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 5 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 5 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Novel biomarkers for acute kidney injury in high-risk pediatric populations: a systematic review.Renal failure · 2026Pooled it
- Urinary L-FABP as an Early Biomarker for Pediatric Acute Kidney Injury Following Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2024Pooled it
- Biomarkers for assessing acute kidney injury for people who are being considered for admission to critical care: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2022Pooled it
- Biomarkers of acute kidney injury in pediatric cardiac surgery.Pediatric nephrology (Berlin, Germany) · 2022Pooled it
- Accuracy of cystatin C in prediction of acute kidney injury in children; serum or urine levels: which one works better? A systematic review and meta-analysis.BMC nephrology · 2017Pooled it
- Explainable machine learning using urinary metabolomics to predict pediatric sepsis-associated acute kidney injury: a two-center prospective observational study.Renal failure · 2026Observational
- The clinical outcomes of acute kidney injury substages based on serum cystatin C in pediatric patients undergoing cardiac surgery.Renal failure · 2025Article
- Authors' Reply: Long-Term Kidney Outcomes after Pediatric Acute Kidney Injury: Future Studies Need to Explore Further.Journal of the American Society of Nephrology : JASN · 2025Article
- Acute kidney injury following treatment with CD19-specific CAR T-cell therapy in children, adolescent, and young adult patients with B-cell acute lymphoblastic leukemia.Pediatric nephrology (Berlin, Germany) · 2024Article
- Integrating multiple kidney function markers to predict all-cause and cardiovascular disease mortality: prospective analysis of 366 758 UK Biobank participants.Clinical kidney journal · 2024Article
- Article
- Acute kidney injury following treatment with CD19-specific CAR T-cell therapy in children, adolescent and young adult patients with B-cell acute lymphoblastic leukemia.Research square · 2023Article
- Using Serum Cystatin C to Predict Acute Kidney Injury Following Infant Cardiac Surgery.Pediatric cardiology · 2023Observational
- Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery.Journal of clinical medicine · 2023Article
- Role of serum cystatin C in the prediction of acute kidney injury following pediatric cardiac surgeries: A single center experience.Medicine · 2022Observational
- In PICU acute kidney injury stage 3 or mortality is associated with early excretion of urinary renin.Pediatric research · 2022Article
- Assessing the value of serum and urinary interleukins for diagnosis of acute kidney injury in children and adolescents: A systematic review and meta-analysis.Practical laboratory medicine · 2022Review
- A nomogram based on serum cystatin C for predicting acute kidney injury in patients with traumatic brain injury.Renal failure · 2021Observational
- Using kinetic eGFR to identify acute kidney injury risk in children undergoing cardiac transplantation.Pediatric research · 2021Article
- Impact of and risk factors for pediatric acute kidney injury defined by the pROCK criteria in a Chinese PICU population.Pediatric research · 2021Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
Abstract
importanceResearch has identified improved biomarkers of acute kidney injury (AKI). Cystatin C (CysC) is a better glomerular filtration rate marker than serum creatinine (SCr) and may improve AKI definition.
objectiveTo determine if defining clinical AKI by increases in CysC vs SCr alters associations with biomarkers and clinical outcomes. DESIGN, SETTING, AND
participantsThree-center prospective cohort study of intensive care units in New Haven, Connecticut, Cincinnati, Ohio, and Montreal, Quebec, Canada. Participants were 287 patients 18 years or younger without preoperative AKI or end-stage renal disease who were undergoing cardiac surgery. The study dates were July 1, 2007, through December 31, 2009. EXPOSURES: For biomarker vs clinical AKI associations, the exposures were first postoperative (0-6 hours after surgery) urine interleukin 18, neutrophil gelatinase-associated lipocalin, kidney injury molecule 1, and liver fatty acid-binding protein. For clinical AKI outcome associations, the exposure was Kidney Disease: Improving Global Outcomes AKI definition (based on SCr or CysC). MAIN OUTCOMES AND MEASURES: Clinical AKI, length of stay, and length of mechanical ventilation. We determined areas under the receiver operating characteristic curve and odds ratios for first postoperative biomarkers to predict AKI.
resultsThe SCr-defined vs CysC-defined AKI incidence differed substantially (43.6% vs 20.6%). Percentage agreement was 71% (κ = 0.38); stage 2 or worse AKI percentage agreement was 95%. Interleukin 18 and kidney injury molecule 1 discriminated for CysC-defined AKI better than for SCr-defined AKI. For interleukin 18 and kidney injury molecule 1, the areas under the receiver operating characteristic curve were 0.74 and 0.65, respectively, for CysC-defined AKI, and 0.66 and 0.58, respectively, for SCr-defined AKI. Fifth (vs first) quintile concentrations of both biomarkers were more strongly associated with CysC-defined AKI. For interleukin 18 and kidney injury molecule 1, the odds ratios were 16.19 (95% CI, 3.55-73.93) and 6.93 (95% CI, 1.88-25.59), respectively, for CysC-defined AKI vs 6.60 (95% CI, 2.76-15.76) and 2.04 (95% CI, 0.94-4.38), respectively, for SCr-defined AKI. Neutrophil gelatinase-associated lipocalin and liver fatty acid-binding protein associations with both definitions were similar. The CysC definitions and SCr definitions were similarly associated with clinical outcomes of resource use. CONCLUSIONS AND RELEVANCE: Compared with the SCr-based definition, the CysC-based definition is more strongly associated with urine interleukin 18 and kidney injury molecule 1 in children undergoing cardiac surgery. Consideration should be made for defining AKI based on CysC in clinical care and future studies.
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