AI Article Synopsis
Article Abstract
Key Points: Complement activation, specifically factor B, is implicated in AKI pathogenesis in animal models. Urine Ba (an activation fragment of factor B) was significantly higher in critically ill children with stage 3 AKI and sepsis-AKI. If larger studies show similar association between urine Ba and AKI severity, clinical trials of factor B inhibition are warranted.
Background:: Critically ill children with AKI have high morbidity and mortality rates and lack treatment options. Complement activation is implicated in AKI pathogenesis, which could be treated with complement-targeted therapeutics. We assessed for an association between urine Ba, an activation fragment of the alternative complement pathway, and AKI in a large cohort of critically ill children.
Methods:: A biorepository of children requiring mechanical ventilation was leveraged. AKI was based on pediatric version of the RIFLE criteria—stage 1: 25% decreased eGFR or urine output (UOP) <0.5ml/kg per hour for 8 hours; stage 2: 50% decreased eGFR or UOP <0.5 ml/kg per hour for 16 hours; stage 3: 75% decreased eGFR or UOP <0.3ml/kg per hour for 24 hours or anuric for 12 hours. ELISAs were performed to quantitate urine Ba values. Log Ba was used in ANOVA with pairwise comparison by the Tukey method. Logistic regression was performed to test the association between urine Ba and AKI diagnosis.
Results:: Seventy-three patients were included, of which 56 had AKI: 26 (46%) stage 1, 16 (29%) stage 2, and 14 (25%) stage 3. Ba was significantly higher in patients with stage 3 AKI compared with all other stages. Ba was higher in sepsis-associated AKI compared with non–sepsis-associated AKI. Multivariate analysis included urine Ba, urine IL-18, urine NGAL, sepsis, and Pediatric Risk of Mortality Scores-II (an estimate of illness severity) and showed a significant association between urine Ba and AKI (odds ratio 1.57, 95% confidence interval, 1.13 to 2.20; 0.007).
Conclusion:: Urine Ba is significantly increased in patients with AKI compared with patients without AKI. In patients with similar illness severity, a doubling of urine Ba level was associated with a 57% increase in AKI diagnosis of any stage. Further studies are needed to study complement inhibition in treatment or prevention of AKI in critically ill children.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103361 | PMC |
| http://dx.doi.org/10.34067/KID.0000000000000077 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa.
Afr J Emerg Med
March 2025
Department of Emergency Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Background: Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access.
View Article and Find Full Text PDFClinical and radiological insights into fibrodysplasia ossificans progressiva: A report on two cases.
J Clin Orthop Trauma
January 2025
Department of Pediatric Orthopaedics, India.
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic illness marked by progressive heterotopic ossification of tendons, ligaments, fascia, and skeletal muscle, leading to immobility and reduced quality of life. Early recognition is critical to avoiding flare-ups often triggered by trivial trauma or medical interventions. This report presents two early-diagnosed FOP cases-one at 6 months, the other at 18 months-both with typical features and congenital great toe abnormalities.
View Article and Find Full Text PDFComparative analysis of formulae for umbilical venous catheterization depth based on birth weight.
Pediatr Investig
December 2024
Department of Neonatology, Neonatal Center, Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.
Importance: Umbilical venous catheterization (UVC) is a common procedure for critically ill newborn infants. The insertion depth was estimated before the procedure using various formulae.
Objective: To compare the accuracy of five published formulae based on birth weight (BW).
High platelet-to-albumin ratio is associated with 30-day mortality in critically ill patients.
Eur J Med Res
December 2024
Department of Clinical Research Laboratory, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, No.120 Gui Dan Road, Foshan, 528222, China.
Background: The role of inflammation and hypoproteinemia in influencing outcomes of critically ill patients has been widely recognized. However, there is a paucity of research on the prognostic value of the platelet-to-albumin ratio (PAR) in critically ill patients. Therefore, the aim of this study is to assess the prognostic significance of PAR in this population.
View Article and Find Full Text PDFMachine learning for predicting acute myocardial infarction in patients with sepsis.
Sci Rep
December 2024
Department of Critical Care Medicine, The Second Hospital of Dalian Medical University, Dalian Medical University, Dalian, 116000, Liaoning, China.
Acute myocardial infarction (AMI) and sepsis are the leading causes of high mortality rates in intensive care units. While sepsis frequently affects the cardiovascular system, distinguishing between sepsis-induced cardiomyopathy and AMI remains challenging due to overlapping biomarkers. Misdiagnosis can hinder timely treatment and increase risk of complications.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!