serum kim-1 and cystatin levels as the predictors of acute kidney injury in asphyxiated neonates

Background: asphyxia may lead to serious complications, among which acute kidney injury (aki) is the most common. early diagnosis of aki can help prevent impaired acid-base, fluid, and electrolyte balance that may lead to life-threatening complications. this study aimed to evaluate the effect of kidney injury molecule-1 (kim-1) and cystatin-c in the early diagnosis of aki among asphyxiated neonates.methods: this case-control study was conducted on 45 asphyxiated neonates, 24 of whom were in the control group and 23 cases were in the case group. creatinine (cr), kim-1, and cystatin-c were measured for participants within 8 h and 4 days after birth and compared between case and control groups.results: the mean level of cr-standardized kim-1 measured within 8 h and 4 days after birth was significantly higher in the case group, compared to the control group (p-value<0.05). the mean level of cr-standardized cysteine, only 4 days after birth, was significantly higher in the case group, compared to the control group (p-value<0.05). a receiver operating characteristic (roc) curve analysis demonstrated that between the two biomarkers with two measurements, the kim-1 cr-standardized within 4 days had the highest area under the curve (auc) (0.751, 95% ci: 0.597-0.905). moreover, the results of roc curve analysis showed that cr-standardized kim-1 within 4 days after birth with a critical value of >0.67 ng/ml allowed to predict kidney failure in newborns with 57.1‌% sensitivity and 86.4‌% specificity.conclusion: the findings of the present study show that high-specificity kim-1 is a good biomarker for the early detection of acute renal failure in asphyxiated infants; however, similar expectations cannot exist with regards to cystatin-c for at least the first 8 h after birth.