| Title |
Chitinase-3-like 1 is a biomarker of acute kidney injury and mortality in paediatric severe malaria
|
|---|---|
| Published in |
Malaria Journal, February 2018
|
| DOI | 10.1186/s12936-018-2225-5 |
| Pubmed ID | |
| Authors |
Andrea L. Conroy, Michael T. Hawkes, Robyn Elphinstone, Robert O. Opoka, Sophie Namasopo, Christopher Miller, Chandy C. John, Kevin C. Kain |
| Abstract |
Chitinase-3-like 1 (CHI3L1) is a glycoprotein elevated in paediatric severe malaria, and an emerging urinary biomarker of acute kidney injury (AKI). Based on the hypothesis that elevated CHI3L1 levels in malaria are associated with disease severity, the relationship between plasma CHI3L1 levels, AKI and mortality was investigated in Ugandan children enrolled in a clinical trial evaluating inhaled nitric oxide (iNO) as an adjunctive therapy for severe malaria. Plasma CHI3L1 levels were measured daily for 4 days in children admitted to hospital with severe malaria and at day 14 follow up. AKI was defined using the Kidney Disease: Improving Global Outcomes consensus criteria. This is a secondary analysis of a randomized double-blind placebo-controlled trial of iNO versus placebo as an adjunctive therapy for severe malaria. Inclusion criteria were: age 1-10 years, and selected criteria for severe malaria. Exclusion criteria included suspected bacterial meningitis, known chronic illness including renal disease, haemoglobinopathy, or severe malnutrition. iNO was administered by non-rebreather mask for up to 72 h at 80 ppm. CHI3L1 was elevated in patients with AKI and remained higher over hospitalization (p < 0.0001). Admission CHI3L1 levels were elevated in children who died. By multivariable analysis logCHI3L1 levels were associated with increased risk of in-hospital death (relative risk, 95% CI 4.10, 1.32-12.75, p = 0.015) and all-cause 6 month mortality (3.21, 1.47-6.98, p = 0.003) following correction for iNO and AKI. Treatment with iNO was associated with delayed CHI3L1 recovery with a daily decline of 34% in the placebo group versus 29% in the iNO group (p = 0.012). CHI3L1 levels correlated with markers of inflammation (CRP, sTREM-1, CXCL10), endothelial activation (Ang-2, sICAM-1) and intravascular haemolysis (LDH, haem, haemopexin). CHI3L1 is a novel biomarker of malaria-associated AKI and an independent risk factor for mortality that is associated with well-established pathways of severe malaria pathogenesis including inflammation, endothelial activation, and haemolysis. Trial registration Clinicaltrials.gov, NCT01255215. Registered December 7th 2010. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Nigeria | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 33% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 88 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 88 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 14% |
| Student > Ph. D. Student | 11 | 13% |
| Student > Master | 10 | 11% |
| Student > Bachelor | 8 | 9% |
| Student > Doctoral Student | 4 | 5% |
| Other | 12 | 14% |
| Unknown | 31 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 24% |
| Biochemistry, Genetics and Molecular Biology | 12 | 14% |
| Nursing and Health Professions | 6 | 7% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 3% |
| Computer Science | 2 | 2% |
| Other | 10 | 11% |
| Unknown | 34 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 February 2018.
All research outputs
#14,876,875
of 24,400,706 outputs
Outputs from Malaria Journal
#3,892
of 5,827 outputs
Outputs of similar age
#256,142
of 482,510 outputs
Outputs of similar age from Malaria Journal
#86
of 128 outputs
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