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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Background Copeptin is a promising biomarker for determining the prognosis of many diseases such as vasopressin-dependent fluid disorders. Objective To assess the role of serum copeptin measurement in critically ill hyponatremic children admitted to the pediatric ICU. Patients and methods This prospective cohort study was conducted on 80 critically ill children and 80 healthy controls. Serum copeptin was measured within the first 24 h of pediatric ICU admission using enzyme-linked immunosorbent assay kits. Results Serum copeptin was significantly elevated among critically ill patients compared with the control group (P < 0.001). There was no significant difference between serum copeptin levels concerning the type of hyponatremia according to volume status, plasma tonicity, or even syndrome of inappropriate antidiuretic hormone secretion diagnosis (P = 0.69, 0.20, and 0.62, respectively). There was no significant difference in serum copeptin levels between survivor and nonsurvivor patients (P = 0.26). On the contrary, there was a significant increase in C-reactive protein, pediatric sequential organ failure assessment, and creatinine in nonsurvivors compared with survivors (P < 0.001, P < 0.001, and P = 0.01, respectively). Moreover, there was a positive correlation between serum copeptin and maximum serum sodium level during the first week (r = 0.394, P < 0.001) and a negative correlation between serum copeptin and serum albumin (r=−0.409, P < 0.001). Conclusion Serum copeptin level, though, is a promising diagnostic and prognostic biomarker for pediatric critical illness, its role in the differential diagnosis of hyponatremic disorders is still limited, and further studies should be done.

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