Serum Cystatin C as an Index of Early Detection of Acute Kidney Injury in Children With Severe Malaria
Bibliographic record
Abstract
Background: Acute kidney injury (AKI) in severe malaria is a major cause of morbidity and mortality. It is often diagnosed using serum creatinine (Scr), which has several limitations. A test for early confirmation of AKI devoid of these limitations is therefore required. Serum cystatin C is therefore suggested as an early screening tool in diagnosing AKI in severe malaria. This study aimed at determining the accuracy of serum cystatin C in the early diagnosis of AKI in severe malaria. Methods: This was a cross-sectional study. Children with World Health Organization (WHO)-defined severe malaria were recruited and AKI was defined using the Kidney Disease: Improving Global Outcomes (KDIGO) and WHO criteria as well as a serum cystatin C level of > 0.95 mg/L. The Scr and cystatin C levels were done and data were analyzed with a P-value less than 5% considered significant. Results: A total of 126 children aged 1 - 15 years comprising 70 (55.6%) males with a male-to-female ratio of 1.25:1 were studied. The prevalence of AKI was 38.9% using serum cystatin C, 23.8% using KDIGO and 11.9% using WHO criteria with statistically significant difference (P = 0.001). The mean serum cystatin C was 0.74 (0.59) mg/L. The sensitivity, specificity, and negative predictive value of cystatin C in the diagnosis of AKI in severe malaria were 80.0%, 73.9%, and 92.2%, respectively using the KDIGO definition of AKI. Conclusion: Serum cystatin C has a high sensitivity, specificity and negative predictive value and can be used to screen children for early detection of AKI in severe malaria. World J Nephrol Urol. 2024;13(1):19-25 doi: https://doi.org/10.14740/wjnu445
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".