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Soluble Urokinase Plasminogen Activator Receptor: A New Biomarker in the Pediatric Intensive Care Unit

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Abstract

Objective

To evaluate the value of soluble urokinase plasminogen activator receptor (suPAR) in diagnosing sepsis and predicting mortality in critically ill children.

Methods

In a prospective cohort study, 69 critically ill children admitted into the pediatric intensive care unit (PICU) were randomly enrolled in addition to 15 healthy children as a control group. Clinical examination was performed, including calculation of the Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality2 (PIM2). suPAR was measured in patients at admission as well as in the controls. Patients were followed up for 30 d.

Results

suPAR level was significantly higher among the total patient cohort compared to controls (p < 0.0001). suPAR was also significantly higher among patients with sepsis compared to both controls (p < 0.0001) and patients without sepsis (p < 0.0001). Furthermore, suPAR level was significantly elevated in non-survivors compared to survivors (p 0.008). Receiver operating characteristic curve (ROC curve) analysis revealed an area under the curve (AUC) of 0.80 for suPAR for diagnosis of sepsis while C-reactive protein (CRP) had an AUC of 0.82. Regarding the prognosis, suPAR had an AUC of 0.69 for prediction of mortality, whereas the AUC for PRISM, PIM2, and CRP were 0.82, 0.81, and 0.77 respectively.

Conclusions

suPAR has both a diagnostic and a prognostic value for critically ill children. However, it does not seem to be superior to the classic laboratory markers and clinical scoring systems.

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Acknowledgments

The authors thank Dr/ Fady M. El-Gendy, Head of the Pediatric Department, Faculty of Medicine, Menoufia University for helpful discussions.

Contributions

Muhammad S. El-Mekkawy and Nagwan Y. Saleh designed the study, analyzed the data, and wrote the manuscript. Ahmed A. Sonbol performed the suPAR measurements. Dr. Fady M. El-Gendy, Head of the Pediatric Department, Faculty of Medicine, Menoufia University will act as guarantor for the paper.

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Authors and Affiliations

  1. Department of Pediatrics, Menoufia University, Menoufia, Egypt

    Muhammad S. El-Mekkawy & Nagwan Y. Saleh

  2. Department of Clinical Pathology, Menoufia University, Menoufia, Egypt

    Ahmed A. Sonbol

Authors
  1. Muhammad S. El-Mekkawy
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  2. Nagwan Y. Saleh
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  3. Ahmed A. Sonbol
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Correspondence to Muhammad S. El-Mekkawy.

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El-Mekkawy, M.S., Saleh, N.Y. & Sonbol, A.A. Soluble Urokinase Plasminogen Activator Receptor: A New Biomarker in the Pediatric Intensive Care Unit. Indian J Pediatr 83, 661–669 (2016). https://doi.org/10.1007/s12098-016-2063-9

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  • DOI: https://doi.org/10.1007/s12098-016-2063-9

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