LI YANHONG1, LI MENGXIA1, LI XIAOZHONG1, FENG XING2 1Department of nephrology, Children’s Hospital of Soochow University; 2Department of neonatology, Children’s Hospital of Soochow University Introduction: Acute kidney injury (AKI) is an independent risk factor for mortality. Since multiple selleck inhibitor factors that influence kidney function and predispose to the development of AKI occur in combination in the neonates, critically ill neonates are at a high risk of having AKI. Cystatin-C is normally filtered freely and completely reabsorbed and catabolized in the proximal tubule. The appearance of increased concentrations of CysC in urine reflects renal tubular injury. In neonates, urinary cystatin-C is demonstrated to be a biomarker

for predicting AKI. This study evaluated the value of urinary cystatin-C level during the first day of life and determined whether urinary cystatin-C can predict mortality in the critically ill neonatal population. Methods: We enrolled 98 critically ill neonates who were admitted to a neonatal intensive care unit this website during the first day of life between July 2010 and April 2011. Urinary samples were collected in the first 24 hours after admission, and the level of cystatin-C was determined. The score for neonatal acute physiology (SNAP) were calculated during the first

24 hours after admission. Major outcome measure was 30-days mortality. Results: Of the 98 neonates, 7 (7.1%) died during the first 30 days of life. The median (min-max range) urinary cystatin-C level in critically ill children was 0.6 mg/g urinary Creatinine (0.0–65.5). The urinary cystatin-C level during the first day of life was significantly associated with 30-days mortality (odds ratio [OR] = 1.28; 95% confidence interval [CI], 1.02–1.60; p = 0.030), even after adjustment for gestational age, gender, and the severity of illness assessed by the SNAP score. Multivariate regression analysis showed

that high urinary cystatin-C level, high SNAP score (OR = 1.24; 95% CI, 1.01–1.53; p = 0.041), and mechanical ventilation (OR = 15.79; 95% CI, 1.69–153.10; p = 0.017) were independent risk factors for 30-days mortality in generally critically ill neonates. Urinary cystatin-C achieved an area under-the-receiver-operating-characteristic curve (AUC) of 0.85 (95% CI, 0.74–0.96; p = 0.005) for predicting 30-days mortality, which was Arachidonate 15-lipoxygenase similar to SNAP (AUC = 0.83; 95% CI, 0.71–0.95; p = 0.008). Urinary cystatin-C displayed a sensitivity of 83% and a specificity of 80% to predict 30-days mortality at an optimal cut-off value. Conclusion: A high urinary level of cystatin-C during the first day of life is independently associated with and predictive of 30-days mortality in the general population of critically ill neonates. JEYAKUMAR YOGARANI1, AGUIAR SANDRA2 1Monash Health; 2Monash Health Introduction: Focal Segmental Glomerulosclerosis(FSGS) is a glomerular disease that can affect both children and adults.