ArticleJournal of nephrology2023
Usefulness of urinary calprotectin as a novel marker differentiating functional from structural acute kidney injury in the critical care setting.
Article in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Improving pediatric post-acute kidney injury care: considerations for the clinician.Renal failure · 2026Review
- Urinary Calprotectin Is Not a Reliable Surrogate of Fecal Calprotectin Levels in Adults and Children with Crohn's Disease.Digestive diseases and sciences · 2026Article
- TIMP-2 and IGFBP7 for the differentiation of functional and intrinsic pediatric acute kidney injury.Pediatric research · 2026Article
- Untargeted Urinary Proteomics Uncovers Nephroprotective and Systemic Adaptations after Obesity Surgery-Induced Weight Loss.Journal of proteome research · 2026Article
- S100A8/A9 in Kidney Diseases: Mechanisms, Spatiotemporal Regulation, Biomarker Potential, and Therapeutic Implications.Journal of inflammation research · 2026Review
- From acute kidney injury to chronic kidney disease in children: maladaptive repair and the need for long-term surveillance - a literature review.BMC nephrology · 2025Review
- New Markers of Early Kidney Damage in Children and Adolescents with Simple Obesity.International journal of molecular sciences · 2024Article
- Acute Kidney Injury in Children: A Focus for the General Pediatrician.Children (Basel, Switzerland) · 2024Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBiomarkers are fundamental tools for differentiating between types of acute kidney injury (AKI) and may thus be crucial in management and prognosis. We report on a recently described biomarker, calprotectin, that appears to be a promising candidate in differentiating hypovolemic/functional AKI from intrinsic/structural AKI, whose acknowledgement may play a role in improving outcomes. We aimed to study the efficacy of urinary calprotectin in differentiating these two forms of AKI. The effect of fluid administration on the subsequent clinical course of AKI, its severity and the outcomes were also studied. METHODOLOGY: Children who presented with conditions predisposing to AKI or with diagnosis of AKI were included. Urine samples for calprotectin analysis were collected and stored at - 20 ºC for analysis at the end of the study. Fluids were administered as per clinical conditions, followed by intravenous furosemide 1 mg/kg, and patients were observed closely for at least 72 h. Children with serum creatinine normalization and clinical improvement were classified as with functional AKI, while those with no response were classified as with structural AKI. Urine calprotectin levels between these two groups were compared. Statistical analysis was performed with SPSS 21.0 software.
resultsOf the 56 children enrolled, 26 were classified as with functional AKI and 30 as with structural AKI. Stage 3 AKI was observed in 48.2% of patients and stage 2 AKI in 33.8%. Mean urine output, creatinine and stage of AKI improved with fluid and furosemide or furosemide alone (OR 6.08, 95% CI 1.65-27.23) (p < 0.01). A positive response to fluid challenge was in favor of functional AKI (OR 6.08, 95% CI 1.65-27.23) (p = 0.008). Presence of edema, sepsis and need for dialysis were hallmarks of structural AKI (p < 0.05). Urine calprotectin/creatinine values were 6 times higher in structural AKI compared to functional AKI. Urine calprotectin/creatinine ratio showed the best sensitivity (63.3%) and specificity (80.7%) at a cut-off value of 1 mcg/mL in differentiating the two types of AKI.
conclusionUrinary calprotectin is a promising biomarker that may help differentiating structural from functional AKI in children.
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