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June 27, 2026Pediatric Critical Care Medicine

Urinary Neutrophil Gelatinase-Associated Lipocalin and Serum Cystatin C as Early Biomarkers of Acute Kidney Injury in Critically Ill Children: Single-Center PICU Cohort, 2024–2025

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Authors

AFAna Rita FradiqueHospitais da Universidade de CoimbraMFMariana FerreiraUniversity of CoimbraARAlexandra Costa RodriguesHospitais da Universidade de Coimbra

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Overview

Single-center cohort study identifies urinary biomarkers for early detection of AKI in critically ill children, suggesting effective diagnostic tools.

Key Points

  • This study aims to evaluate urinary neutrophil gelatinase-associated lipocalin and serum cystatin C as early biomarkers for acute kidney injury in critically ill children.
  • Single-center cohort study conducted in a pediatric intensive care unit (PICU).
  • Analyzed 75 patients over 10 months, focusing on biomarkers and clinical parameters associated with AKI.
  • Measured uNGAL and Cys-C levels on days 1-3 to assess their relationship with AKI development.
  • AKI developed in 22 patients (29.3%); uNGAL showed significant elevation on days 1, 2, and 3 (p < 0.001, p = 0.003, p = 0.013 respectively).
  • Cystatin C was elevated on day 1 only (p = 0.013); good-to-excellent discrimination for AKI with uNGAL (AUC 0.847) and blood urea nitrogen (AUC 0.848).
  • Diagnostic uncertainty remained with a 29.3% pretest probability of AKI, rising to 73.1% posttest with uNGAL >87 ng/mL.

Cite This Study

Fradique et al. (2026) studied this question.

synapsesocial.com/papers/6a3f67e2aea7db3c1953f357https://doi.org/10.1097/pcc.0000000000003984
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 145: LEVERAGING URINE BIOMARKERS TO PREDICT ACUTE KIDNEY INJURY IN CRITICALLY ILL CHILDREN2026
  2. 2uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children2022 · 1 citations
  3. 3Derivation and Validation of an Optimal Neutrophil Gelatinase-Associated Lipocalin Cutoff to Predict Stage 2/3 Acute Kidney Injury (AKI) in Critically Ill Children2024 · 33 citations
  4. 4Neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C: potential biomarkers for early prediction of acute kidney injury in pediatric male patients2024
  5. 5The use of urinary biomarkers as prognostic tools: predicting kidney outcomes in pediatric acute kidney injury2025