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Biomarkers of acute kidney injury in pediatric cardiac surgery

Authorized Users Only
2013
Authors
Peco-Antić, Amira
Ivanišević, Ivana
Vulicević, Irena
Kotur-Stevuljević, Jelena
Ilić, Slobodan
Ivanišević, Jasmina
Miljković, Milica
Kocev, Nikola
Article (Published version)
Metadata
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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.

Keywords:
Cardiopulmonary bypass / Acute kidney injury / Cystatin C / NGAL / L-FABP
Source:
Clinical Biochemistry, 2013, 46, 13-14, 1244-1251
Publisher:
  • Pergamon-Elsevier Science Ltd, Oxford
Projects:
  • Interactive role of dyslipidemia, oxidative stress and inflammation in atherosclerosis and other diseases: genetic and biochemical markers (RS-175035)

DOI: 10.1016/j.clinbiochem.2013.07.008

ISSN: 0009-9120

PubMed: 23876402

WoS: 000323857300014

Scopus: 2-s2.0-84882866159
[ Google Scholar ]
35
35
URI
http://farfar.pharmacy.bg.ac.rs/handle/123456789/1893
Collections
  • Radovi istraživača / Researchers’ publications
Institution
Pharmacy
TY  - 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  - http://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",
url = "http://farfar.pharmacy.bg.ac.rs/handle/123456789/1893",
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. Biomarkers of acute kidney injury in pediatric cardiac surgery. Clinical Biochemistry. 2013;46(13-14):1244-1251
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.
Clinical BiochemistryPergamon-Elsevier Science Ltd, Oxford., 46(13-14), 1244-1251.
https://doi.org/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" 46, no. 13-14 (2013):1244-1251,
https://doi.org/10.1016/j.clinbiochem.2013.07.008 .

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