Nutritional biomakers in critically III children with acute Kidney Injury

Abstract EN

background: Acute kidney injury (AKI) is associated with many short term and long term renal impairments as well as increased morbidity mortality in intensive care unit.

Nutritional assessment is an indispensable tool for the evaluation and monitoring of patients with AKI.

The use of nutritional biomarkers may prove some usefulness as screening parameters for worse prognosis and higher mortality in AKI patients.

Aim: The current study aimed to evaluate the correlation between Albumin, Cholesterol and Insulin like growth factor-1 (IGF-1) as nutritional biomarkers and the clinical outcome of acute kidney injury in critically ill children.

Patients and Methods: Study included 42 critically ill patients with age range from 2 months to 5 years.

Serum Albumin, Cholesterol were assayed by spectraphotometric method (Stanbio, USA) at day 3 and 5.

IGF-1 were measured by enzyme- linked immunosorbent assay (R& D systems, USA) at days 3 and 5.

Serum creatinine at days 1 and 3 was assayed by spectrophotometric method (Stanbio, USA).

Results: Out of the 42 patients, 31% developed AKI.

Serum cholesterol was significantly lower in AKI compared to non- AKI group at days 3 and 5 with mean values 80.08+ 32.91 vs 114.41+ 41.58 respectively at day 3, and 87.46± 23.36 vs 121.14± 45.49 respectively at day 5.

While serum albumin showed no statistically significant difference between both groups.

IGF-1 values at day 3 and day 5 were significantly lower in AKI group compared to non-AKI with a median (IQR) 123 (119-140) vs 158 (131- 362) in both groups respectively at day 3, and 124(100-148) vs 210 (143- 287) respectively at day 5.

There was a correlation between serum IGF-1 and mortality only at day 5 in our study.

Conclusion: Malnutrition is a common finding in patients with AKI and leads to worse outcome.

Nutritional biomarkers like Cholesterol and IGF-1 are possible predictors of worse outcome in AKI patients.