Role of Serum Cystatin C Levels in Preterm Neonates with Respiratory Distress Syndrome in Diagnosing Neonatal AKI
Dr. Mohd Ashraf,
30-MIG Colony, Masjid Rehmat, Bemina, Srinagar-90018, Jammu and Kashmir, India.
Introduction: Despite major advances in perinatal and neonatal care in Respiratory Distress Syndrome (RDS) prevention and treatment, a considerable number of these neonates suffer from RDS along with Acute Kidney Injury (AKI), and concomitant occurrence of RDS and AKI in neonates is associated with poor outcome.
Aim: To determine Serum Cystatin C (sCysC) level and Serum Creatinine (sCr) level in preterm neonates with RDS, and to find correlation, if any, between the sCysC level and sCr level in diagnosing neonatal AKI in them.
Materials and Methods: After dividing the preterm neonates into three groups based on Gestational Age (GA): (24-27 weeks; five each in cases and controls; 28-33 weeks; 15 each in cases and controls; and 34-37 weeks; 20 each in cases and controls), two case-control analyses were conducted. In the first one, sCysC levels were compared between neonates with RDS and the control group. In the second one, sCysC levels were compared between neonates having RDS and AKI (RDS-AKI subgroup), neonates having RDS but no AKI (RDS-no AKI subgroup), and the healthy control group. Studentâ€™s Independent t-test was used for statistical analyses.
Results: Out of 80 preterm neonates, 40 had RDS and 40 were healthy without RDS taken as controls. There were 10 neonates with AKI (RDS-AKI sub-group), and 30 neonates with RDS without AKI (RDS-no AKI sub-group). No significant differences in sCr levels were found among the RDS and control subgroups on day 3rd and day 30th of life (p=0.151 and 0.658). Serum Cystatin C levels in the RDS-AKI subgroup were significantly higher than in both the RDS-no AKI subgroup and the control group on day-3 (p<0.001). Statistically significant differences in birth weights were observed among the RDS-AKI, RDS-no AKI and control subgroups as depicted in (p=0.025).
Conclusion: sCysC is an independent predictor of AKI in preterm neonates with RDS.