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Serum lactate as reliable biomarker of acute kidney injury in low-risk cardiac surgery patients

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2019
3309.pdf (110.1Kb)
Authors
Radović, Mina
Bojić, Suzana
Kotur-Stevuljević, Jelena
Lezaić, Višnja
Milicić, Biljana
Velinović, Miloš
Karan, Radmila
Simić-Ogrizović, Sanja
Article (Published version)
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Abstract
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) frequently occurs in patients assessed as low-risk for developing CSA-AKI. Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule-1 (KIM-1) and lactate are promising biomarkers of CSA-AKI but have not yet been explored in low-risk patients. Aim: To evaluate urinary NGAL (uNGAL), KIM-1 and lactate as biomarkers of CSA-AKI in patients with low-risk for developing CSA-AKI. Methods: This prospective, observational study included 100 adult elective cardiac surgery patients assessed as low-risk for developing CSA-AKI. UNGAL, KIM-1 and lactate were measured preoperatively, at the end of cardiopulmonary bypass (CPB) and 3, 12, 24 and 48 h later. Results: Fifteen patients developed CSA-AKI. Patients with CSA-AKI had significantly higher lactate but similar uNGAL and KIM-1 levels compared to patients without CSA-AKI. Unlike uNGAL and KIM-1, postoperative lactate was good biomarker of CSA-AKI with the highest ...odds ratio (OR) 2.7 [1.4-4.9] 24 h after CPB. Peak lactate concentration >= 4 mmol/L carried dramatically higher risk for developing CSA-AKI (OR 6.3 [1.9-20.5]). Conclusions: Unlike uNGAL and KIM-1, postoperative lactate was significant independent predictor of CSA-AKI with the highest odds ratio 24 h after CPB.

Keywords:
acute kidney injury / cardiac surgery / Kidney Injury Molecule-1 / lactate / Neutrophil Gelatinase-Associated Lipocalin
Source:
Journal of Medical Biochemistry, 2019, 38, 2, 118-125
Publisher:
  • Društvo medicinskih biohemičara Srbije, Beograd i Versita
Projects:
  • Biomarkers for kidney diseases: diagnostic and prognostic significance (RS-175089)

DOI: 10.2478/jomb-2018-0018

ISSN: 1452-8258

PubMed: 30867639

WoS: 000460757200002

Scopus: 2-s2.0-85049165398
[ Google Scholar ]
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URI
http://farfar.pharmacy.bg.ac.rs/handle/123456789/3311
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  • Radovi istraživača / Researchers’ publications
Institution
Pharmacy

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