Biomarkers of AKI Progression after Pediatric Cardiac Surgery.

Journal of the American Society of Nephrology : JASN
Jason H GreenbergChirag R Parikh

Abstract

Background As children progress to higher stages of AKI, the risk for adverse outcomes dramatically increases. No reliable methods exist to predict AKI progression in hospitalized children. To determine if biomarkers of inflammation and kidney injury can predict AKI progression, we conducted a three-center prospective cohort study of children undergoing cardiopulmonary bypass.Methods On the first day of serum creatinine-defined AKI, we measured urine biomarkers (neutrophil gelatinase-associated lipocalin [NGAL], IL-18, kidney injury molecule 1, liver fatty acid binding protein [L-FABP], albumin, and cystatin C) and plasma biomarkers (IFN, IL-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, TNF-α, NGAL, and cystatin C). We defined AKI progression as a worsening of AKI stage or persisting stage 3 AKI (≥2 consecutive days).Results In all, 176 of 408 (43%) children developed postoperative AKI. Among the children with AKI, we diagnosed stages 1, 2, and 3 AKI in 145 (82.5%), 25 (14%), and six (3.5%) children, respectively, on the first day of AKI; 28 (7%) children had AKI progression. On the first day of AKI, nine of 17 biomarkers were significantly higher in patients with than without AKI progression. Urine L-FABP (among injury bioma...Continue Reading

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Citations

Feb 11, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ioannis BellosDespina N Perrea
May 14, 2020·Clinical Pediatrics·William PrimackStephanie Jernigan
Jul 17, 2019·World Journal for Pediatric & Congenital Heart Surgery·Devin M ParkerJeremiah R Brown
May 10, 2020·Critical Care : the Official Journal of the Critical Care Forum·Jia-Jin ChenGeorge Kuo
Nov 3, 2020·Journal of the American Heart Association·Zhongli ChenChenglong Xiong
Nov 27, 2020·Frontiers in Physiology·Zujun ChenJiangping Song
Nov 13, 2019·JACC. Basic to Translational Science·Yang Chen, John C Burnett
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