Changes in the concentrations of creatinine, cystatin C and NGAL in patients with acute paraquat self-poisoning

Roberts, Roberts, Darren M., Wilks, Martin F., Roberts, Michael S., Swaminathan, Ramasamyiyer, Mohamed, Fahim, Dawson, Andrew H. and Buckley, Nick A. (2011) Changes in the concentrations of creatinine, cystatin C and NGAL in patients with acute paraquat self-poisoning. Toxicology Letters, 202 1: 69-74. doi:10.1016/j.toxlet.2011.01.024


Author Roberts, Roberts, Darren M.
Wilks, Martin F.
Roberts, Michael S.
Swaminathan, Ramasamyiyer
Mohamed, Fahim
Dawson, Andrew H.
Buckley, Nick A.
Title Changes in the concentrations of creatinine, cystatin C and NGAL in patients with acute paraquat self-poisoning
Journal name Toxicology Letters   Check publisher's open access policy
ISSN 0378-4274
1879-3169
Publication date 2011-04-01
Sub-type Article (original research)
DOI 10.1016/j.toxlet.2011.01.024
Open Access Status DOI
Volume 202
Issue 1
Start page 69
End page 74
Total pages 6
Place of publication Shannon, Co. Clare Ireland
Publisher Elsevier Ireland
Language eng
Subject 3005 Toxicology
Abstract An increase in creatinine >3 μmol/L/h has been suggested to predict death in patients with paraquat self-poisoning and the value of other plasma biomarkers of acute kidney injury has not been assessed. The aim of this study was to validate the predictive value of serial creatinine concentrations and to study the utility of cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) as predictors of outcome in patients with acute paraquat poisoning. The rate of change of creatinine (dCr/dt) and cystatin C (dCyC/dt) concentrations were compared between survivors and deaths. Receiver-operating characteristic (ROC) curves were constructed to determine the best threshold for predicting death. Paraquat was detected in 20 patients and 7 of these died between 18 h and 20 days post-ingestion. The dCr/dt ROC curve had an area of 0.93 and the cut-off was >4.3 μmol/L/h (sensitivity 100%, specificity 85%, likelihood ratio 7). The dCyC/dt ROC curve had an area of 0.97 and the cutoff was >0.009 mg/L/h (sensitivity 100%, specificity 91%, likelihood ratio 11). NGAL did not separate survivors from deaths. Death due to acute paraquat poisoning is associated with changes in creatinine and cystatin concentrations. Further validation of these measurements is needed before they can be adopted in guiding intensive treatments.
Keyword Paraquat
Prognosis
Kidney injury
Human
Creatinine
Biomarker
Cystatin C
NGAL
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Wed, 28 Sep 2011, 21:09:14 EST by Matthew Lamb on behalf of School of Medicine