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Urinary nitrate might be an early biomarker for pediatric acute kidney injury in the emergency department.
MedLine Citation:
PMID:  21532528     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Nitric oxide (NO) is involved in normal kidney function and perturbed in acute kidney injury (AKI). We hypothesized that urinary concentration of NO metabolites, nitrite and nitrate, would be lower in children with early AKI presenting to the emergency department (ED), when serum creatinine (SCr) was uninformative. Patients up to 19 years were recruited if they had a urinalysis and SCr obtained for routine care. Primary outcome, AKI, was defined by pediatric Risk, Injury, Failure, Loss of function, End stage renal disease (pRIFLE) criteria. Urinary nitrite and nitrate were determined by HPLC. A total of 252 patients were enrolled, the majority (93%) of whom were without AKI. Though 18 (7%) had AKI by pRIFLE, 50% may not have had it identified by the SCr value alone at the time of visit. Median urinary nitrate was lower for injury vs. risk (P=0.03); this difference remained significant when the injury group was compared against the combined risk and no AKI groups (P=0.01). Urinary nitrite was not significantly different between groups. Thus, low urinary nitrate is associated with AKI in the pediatric ED even when SCr is normal. Predictive potential of this putative urinary biomarker for AKI needs further evaluation in sicker patients. ABBREVIATIONS:
Authors:
Asad I Mian; Yue Du; Harsha K Garg; A Chantal Caviness; Stuart L Goldstein; Nathan S Bryan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-28
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-5-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatrics [A.I.M., Y.D., A.C.C.], Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030; Department of Pediatrics [S.L.G.], Cincinnati Children's Hospital, Cincinnati, OH 45229; Texas Therapeutics Institute [H.K.G., N.S.B.], University of Texas Houston Health Science Center, Houston, TX 77030.
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