Proenkephalin as a new biomarker for pediatric acute kidney injury – reference values and performance in children under one year of age

What is it about?

Acute kidney injury (AKI) is a major problem in the intensive care unit, affecting roughly 35% of critically ill adults and children. Currently, AKI is diagnosed using surrogate biomarkers for kidney function, but these biomarkers are suboptimal for detecting AKI in an early stage. Proenkephalin (PENK) is a novel AKI biomarker that has shown promising results in adults, but studies in children are lacking. We present the first PENK data in children in which we determined reference ranges for PENK in a population of 100 healthy children 0 - 1 year of age without AKI. Additionally we studied the performance of PENK in 91 similarly aged critically ill children with or without AKI. We show PENK values are markedly higher in these young children compared to adults. Nonetheless, PENK was able to discriminate patients with and without AKI, at least comparable to currently used biomarkers. These data implicate the importance of determining age-specific reference values for pediatric biomarkers and underline the possible value of PENK as a future AKI biomarker in children.

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