Accuracy of urine calprotectin for diagnosis of acute kidney injury in neonates

Abstract Background: Urine calprotectin significantly rises in acute kidney injury (AKI) in adult and pediatrics. The aim of the present study was to investigate the accuracy of urine calprotectin as a diagnostic marker for (AKI) in neonates. Methods In this cross sectional study, we assessed urine calprotectin in 100 neonates, in which 80 of them had AKI and 20 were healthy. Random urine calprotectin measured by ELISA and then compared between two groups. We included neonates who had received at least 48 hour intra venous fluid and met our inclusion and exclusion criteria. . Receiver-operating characteristic (ROC) curve used to set a cut of point for urine calprotectin to predict AKI. The overall accuracy and Kappa coefficient was used for assess the agreement between two methods.. P value below 0.05 considered significant. Results: Urine calprotectin levels were not significantly higher in neonates with AKI than healthy ones (146.2 vs 142.4, p=0.1). The results showed an optimal cutoff value of 123.5 mg/dl for urine calprotectin with area under the curve of 0•515 with sensitivity, specificity, positive predictive value and negative predictive value of 77.5%,40%,83.7% and 30.7%, respectively. The overall accuracy was 70% and the Kappa agreement coefficient was 0.15 (P=0.11.). Conclusion: Although urine calprotectin level can predict the AKI, it is not accurate measure comparing the gold standard.