{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T12:55:57Z","timestamp":1784120157869,"version":"3.55.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>Acute kidney injury occurs early in PICU admission and increases risks for poor outcomes. We evaluated the feasibility of a multicenter acute kidney injury biomarker urine collection protocol and measured diagnostic characteristics of urine neutrophil gelatinase\u2013associated lipocalin, interleukin-18, and liver fatty acid binding protein to predict acute kidney injury and prolonged acute kidney injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Prospective observational pilot cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Four Canadian tertiary healthcare PICUs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Eighty-one children 1 month to 18 years old. Exclusion criteria were as follows: cardiac surgery, baseline severe kidney disease, and inadequate urine or serum for PICU days 1\u20133.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>PICUs performed standardized urine collection protocol to obtain early PICU admission urine samples, with deferred consent.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Measurements and Main Results:<\/jats:title>\n            <jats:p>Study barriers and facilitators were recorded. Acute kidney injury was defined based on Kidney Disease: Improving Global Outcomes serum creatinine criteria (acute kidney injury<jats:sub>serum creatinine<\/jats:sub>) and by serum creatinine and urine output criteria (acute kidney injury<jats:sub>serum creatinine+urine output<\/jats:sub>) Prolonged acute kidney injury was defined as acute kidney injury duration of 48 hours or more. PICU days 1\u20133 neutrophil gelatinase\u2013associated lipocalin, interleukin-18, and liver fatty acid binding protein were evaluated for acute kidney injury prediction (area under the curve). Biomarkers on the first day of acute kidney injury attainment (day 1 acute kidney injury) were evaluated for predicting prolonged acute kidney injury. Eighty-two to 95% of subjects had urine collected from PICU days 1\u20133. Acute kidney injury<jats:sub>serum creatinine<\/jats:sub> developed in 16 subjects (20%); acute kidney injury<jats:sub>serum creatinine+urine output<\/jats:sub> developed in 38 (47%). On PICU day 1, interleukin-18 predicted acute kidney injury<jats:sub>serum creatinine<\/jats:sub> with area under the curve=0.82, but neutrophil gelatinase\u2013associated lipocalin and liver fatty acid binding protein predicted acute kidney injury<jats:sub>serum creatinine<\/jats:sub> with area under the curve of less than or equal to 0.69; on PICU day 2, area under the curve was higher (not shown). Interleukin-18 and liver fatty acid binding protein on day 1 acute kidney injury predicted prolonged acute kidney injury<jats:sub>serum creatinine<\/jats:sub> (area under the curve=0.74 and 0.83, respectively). When acute kidney injury<jats:sub>serum creatinine+urine output<\/jats:sub> was used to define acute kidney injury, biomarker area under the curves were globally lower.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Protocol urine collection to procure early admission samples is feasible. Individual biomarker acute kidney injury prediction performance is highly variable and modest. Larger studies should evaluate utility and cost effectiveness of using early acute kidney injury biomarkers.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pcc.0000000000001183","type":"journal-article","created":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T06:57:49Z","timestamp":1492757869000},"page":"e235-e244","source":"Crossref","is-referenced-by-count":15,"title":["Biomarkers for Early Acute Kidney Injury Diagnosis and Severity Prediction: A Pilot Multicenter Canadian Study of Children Admitted to the ICU"],"prefix":"10.1097","volume":"18","author":[{"given":"Jennifer","family":"Palermo","sequence":"first","affiliation":[{"name":"Divisions of Nephrology and Pediatric Critical Care Medicine, Department of Pediatrics, Montreal Children\u2019s Hospital, McGill University Health Centre, Montreal, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison B.","family":"Dart","sequence":"additional","affiliation":[{"name":"Section of Nephrology, 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Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Garcia Guerra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Women and Children\u2019s Health Research Institute, Edmonton, AL, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Hansen","sequence":"additional","affiliation":[{"name":"Section of Pediatric Intensive Care, Department of Pediatrics and Child Health, University of Manitoba, Children\u2019s Hospital, Winnipeg, Manitoba, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari R.","family":"Joffe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Women and Children\u2019s Health Research Institute, Edmonton, AL, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherry","family":"Mammen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, British Columbia Children\u2019s Hospital, University of British Columbia, Vancouver, BC, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Majesic","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, University of Alberta, Edmonton, AL, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Morgan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, University of Alberta, Edmonton, AL, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Skippen","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Children\u2019s Heart Centre, British Columbia Children\u2019s Hospital, Vancouver, BC, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pizzi","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology and 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