Biomarkers of acute kidney injury in pediatric cardiac surgery
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2013
Authors
Peco-Antić, AmiraIvanišević, Ivana
Vulicević, Irena
Kotur-Stevuljević, Jelena

Ilić, Slobodan
Ivanišević, Jasmina

Miljković, Milica

Kocev, Nikola
Article (Published version)

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Objectives: Acute kidney injury (AKI) is a significant problem in children undergoing cardiopulmonary bypass (CPB). The aims of this study were to assess the diagnostic validity of serum CysC (sCysC), serum neutrophil gelatinase lipocalin (sNGAL), urine neutrophil gelatinase lipocalin (uNGAL), urine kidney injury molecule (uKIM)-1, and urine liver fatty acid-binding protein (uL-FABP) to predict AKI presence and severity in children undergoing CPB. Design and methods: We performed a prospective single-center evaluation of sCysC, sNGAL, uNGAL, uKIM-1 and uL-FABP at 0, 2, 6, 24 and 48 h postoperatively in children undergoing CPB during cardiac surgery. AKI was defined as >= 25% decrease in the estimated creatinine clearance (eCCl) from pre-operative baseline at 48 h after surgery. Results: Of the 112 patients, 18 patients (16.1%) developed AKI; four of them needed acute dialysis treatment and three AKI patients died. In the AKI compared to the non-AM group, sCysC at 2 h, and uNGAL and uL-...FABP at 2-48 h were significantly increased, as well as CPB, aortic cross clamp time and length of hospital stay. Biomarkers increased with worsening AKI severity. At 2 h after CPB the best accuracy for diagnosis of AKI had uL-FABP and sCysC with area under the receiver operator curve (AUC) of 0.89 and 0.73, respectively. At 6 and 24 h after CPB the best AUC was found for uL-FABP (0.75 and 0.87 respectively) and for uNGAL (0.70 and 0.93, respectively). Conclusions: sCysC, uNGAL and uL-FABP are reliable early predictors for AKI after CPB. By allowing earlier timing of injury and earlier intervention, they could improve AKI outcome.
Keywords:
Cardiopulmonary bypass / Acute kidney injury / Cystatin C / NGAL / L-FABPSource:
Clinical Biochemistry, 2013, 46, 13-14, 1244-1251Publisher:
- Pergamon-Elsevier Science Ltd, Oxford
Funding / projects:
DOI: 10.1016/j.clinbiochem.2013.07.008
ISSN: 0009-9120
PubMed: 23876402
WoS: 000323857300014
Scopus: 2-s2.0-84882866159
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PharmacyTY - JOUR AU - Peco-Antić, Amira AU - Ivanišević, Ivana AU - Vulicević, Irena AU - Kotur-Stevuljević, Jelena AU - Ilić, Slobodan AU - Ivanišević, Jasmina AU - Miljković, Milica AU - Kocev, Nikola PY - 2013 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/1893 AB - Objectives: Acute kidney injury (AKI) is a significant problem in children undergoing cardiopulmonary bypass (CPB). The aims of this study were to assess the diagnostic validity of serum CysC (sCysC), serum neutrophil gelatinase lipocalin (sNGAL), urine neutrophil gelatinase lipocalin (uNGAL), urine kidney injury molecule (uKIM)-1, and urine liver fatty acid-binding protein (uL-FABP) to predict AKI presence and severity in children undergoing CPB. Design and methods: We performed a prospective single-center evaluation of sCysC, sNGAL, uNGAL, uKIM-1 and uL-FABP at 0, 2, 6, 24 and 48 h postoperatively in children undergoing CPB during cardiac surgery. AKI was defined as >= 25% decrease in the estimated creatinine clearance (eCCl) from pre-operative baseline at 48 h after surgery. Results: Of the 112 patients, 18 patients (16.1%) developed AKI; four of them needed acute dialysis treatment and three AKI patients died. In the AKI compared to the non-AM group, sCysC at 2 h, and uNGAL and uL-FABP at 2-48 h were significantly increased, as well as CPB, aortic cross clamp time and length of hospital stay. Biomarkers increased with worsening AKI severity. At 2 h after CPB the best accuracy for diagnosis of AKI had uL-FABP and sCysC with area under the receiver operator curve (AUC) of 0.89 and 0.73, respectively. At 6 and 24 h after CPB the best AUC was found for uL-FABP (0.75 and 0.87 respectively) and for uNGAL (0.70 and 0.93, respectively). Conclusions: sCysC, uNGAL and uL-FABP are reliable early predictors for AKI after CPB. By allowing earlier timing of injury and earlier intervention, they could improve AKI outcome. PB - Pergamon-Elsevier Science Ltd, Oxford T2 - Clinical Biochemistry T1 - Biomarkers of acute kidney injury in pediatric cardiac surgery VL - 46 IS - 13-14 SP - 1244 EP - 1251 DO - 10.1016/j.clinbiochem.2013.07.008 ER -
@article{ author = "Peco-Antić, Amira and Ivanišević, Ivana and Vulicević, Irena and Kotur-Stevuljević, Jelena and Ilić, Slobodan and Ivanišević, Jasmina and Miljković, Milica and Kocev, Nikola", year = "2013", abstract = "Objectives: Acute kidney injury (AKI) is a significant problem in children undergoing cardiopulmonary bypass (CPB). The aims of this study were to assess the diagnostic validity of serum CysC (sCysC), serum neutrophil gelatinase lipocalin (sNGAL), urine neutrophil gelatinase lipocalin (uNGAL), urine kidney injury molecule (uKIM)-1, and urine liver fatty acid-binding protein (uL-FABP) to predict AKI presence and severity in children undergoing CPB. Design and methods: We performed a prospective single-center evaluation of sCysC, sNGAL, uNGAL, uKIM-1 and uL-FABP at 0, 2, 6, 24 and 48 h postoperatively in children undergoing CPB during cardiac surgery. AKI was defined as >= 25% decrease in the estimated creatinine clearance (eCCl) from pre-operative baseline at 48 h after surgery. Results: Of the 112 patients, 18 patients (16.1%) developed AKI; four of them needed acute dialysis treatment and three AKI patients died. In the AKI compared to the non-AM group, sCysC at 2 h, and uNGAL and uL-FABP at 2-48 h were significantly increased, as well as CPB, aortic cross clamp time and length of hospital stay. Biomarkers increased with worsening AKI severity. At 2 h after CPB the best accuracy for diagnosis of AKI had uL-FABP and sCysC with area under the receiver operator curve (AUC) of 0.89 and 0.73, respectively. At 6 and 24 h after CPB the best AUC was found for uL-FABP (0.75 and 0.87 respectively) and for uNGAL (0.70 and 0.93, respectively). Conclusions: sCysC, uNGAL and uL-FABP are reliable early predictors for AKI after CPB. By allowing earlier timing of injury and earlier intervention, they could improve AKI outcome.", publisher = "Pergamon-Elsevier Science Ltd, Oxford", journal = "Clinical Biochemistry", title = "Biomarkers of acute kidney injury in pediatric cardiac surgery", volume = "46", number = "13-14", pages = "1244-1251", doi = "10.1016/j.clinbiochem.2013.07.008" }
Peco-Antić, A., Ivanišević, I., Vulicević, I., Kotur-Stevuljević, J., Ilić, S., Ivanišević, J., Miljković, M.,& Kocev, N.. (2013). Biomarkers of acute kidney injury in pediatric cardiac surgery. in Clinical Biochemistry Pergamon-Elsevier Science Ltd, Oxford., 46(13-14), 1244-1251. https://doi.org/10.1016/j.clinbiochem.2013.07.008
Peco-Antić A, Ivanišević I, Vulicević I, Kotur-Stevuljević J, Ilić S, Ivanišević J, Miljković M, Kocev N. Biomarkers of acute kidney injury in pediatric cardiac surgery. in Clinical Biochemistry. 2013;46(13-14):1244-1251. doi:10.1016/j.clinbiochem.2013.07.008 .
Peco-Antić, Amira, Ivanišević, Ivana, Vulicević, Irena, Kotur-Stevuljević, Jelena, Ilić, Slobodan, Ivanišević, Jasmina, Miljković, Milica, Kocev, Nikola, "Biomarkers of acute kidney injury in pediatric cardiac surgery" in Clinical Biochemistry, 46, no. 13-14 (2013):1244-1251, https://doi.org/10.1016/j.clinbiochem.2013.07.008 . .