title: Cystatin C and neutrophil gelatinase-associated lipocalin as markers of renal function in pediatric heart transplant recipients.
abstract: We hypothesized that use of Schwartz formula underestimates the prevalence of CKD in PHT recipients. This study determined the prevalence and risk factors for CKD in PHT using novel methods-serum cystatin C, CKiD formula, Revised Schwartz formula, s- and u-NGAL. Serum BUN, creatinine, cystatin C and s- and u-NGAL were measured after prospective enrollment. Schwartz formula GFR was compared with novel methods. CKD was defined as CKiD GFR < 90 mL/min/1.73 m(2) . The s- and u-NGAL were compared between those with and without CKD. Potential risk factors for CKD were analyzed. Seventy-nine patients (46 male children or boys), mean age 9.9 ± 5.8 yr formed the study cohort. The prevalence of mild and moderate CKD was 2- to 3-fold higher using novel methods compared to Schwartz formula. u-NGAL and u-NGAL/Cr were significantly higher in patients with CKD. u- and s-NGAL had negative correlation with estimates of GFR. Women were at a higher risk for CKD (odds ratio 8.7) as was longer duration since transplant (p = 0.009). In conclusion, use of novel methods of GFR estimation unmasked 2- to 3-fold increased prevalence of CKD in PHT. Women and those with longer duration since transplant are at higher risk for CKD.
authors.affiliation: Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA. bpabraham@uams.edu
authors.forename: Boban P
authors.initials: BP
authors.lastname: Abraham
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Frazier
authors.forename: W Robert
authors.initials: WR
authors.lastname: Morrow
authors.forename: Richard T
authors.initials: RT
authors.lastname: Blaszak
authors.forename: Prasad
authors.initials: P
authors.lastname: Devarajan
authors.forename: Mark
authors.initials: M
authors.lastname: Mitsnefes
authors.forename: Janet C
authors.initials: JC
authors.lastname: Bryant
authors.forename: Ritu
authors.initials: R
authors.lastname: Sachdeva
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D001806:Blood Urea Nitrogen; D002648:Child; D055316:Cystatin C / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000473:pathology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism*; D008297:Male; D016017:Odds Ratio; D011518:Proto-Oncogene Proteins / Q000378:metabolism*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins