Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery
Background Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (...
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| Format: | Article |
| Language: | English |
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The Korean Pediatric Society
2020-04-01
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| Series: | Clinical and Experimental Pediatrics |
| Subjects: | |
| Online Access: | http://www.e-cep.org/upload/pdf/cep-2019-00913.pdf |
| _version_ | 1828401993191784448 |
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| author | Hee Sun Baek Youngok Lee Hea Min Jang Joonyong Cho Myung Chul Hyun Yeo Hyang Kim Su-Kyeong Hwang Min Hyun Cho |
| author_facet | Hee Sun Baek Youngok Lee Hea Min Jang Joonyong Cho Myung Chul Hyun Yeo Hyang Kim Su-Kyeong Hwang Min Hyun Cho |
| author_sort | Hee Sun Baek |
| collection | DOAJ |
| description | Background Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery. Purpose This study aimed to investigate the clinical usefulness of these biomarkers in young children. Methods Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated. Results Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery. Conclusion It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases. |
| first_indexed | 2024-12-10T09:54:15Z |
| format | Article |
| id | doaj.art-2778362e1568456a967374524b4b0954 |
| institution | Directory Open Access Journal |
| issn | 2713-4148 |
| language | English |
| last_indexed | 2024-12-10T09:54:15Z |
| publishDate | 2020-04-01 |
| publisher | The Korean Pediatric Society |
| record_format | Article |
| series | Clinical and Experimental Pediatrics |
| spelling | doaj.art-2778362e1568456a967374524b4b09542022-12-22T01:53:33ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482020-04-0163415115610.3345/cep.2019.0091320125553619Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgeryHee Sun Baek0Youngok Lee1Hea Min Jang2Joonyong Cho3Myung Chul Hyun4Yeo Hyang Kim5Su-Kyeong Hwang6Min Hyun Cho7 Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, Kyungpook National University, School of Medicine, Daegu, Korea Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, Kyungpook National University, School of Medicine, Daegu, Korea Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, KoreaBackground Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery. Purpose This study aimed to investigate the clinical usefulness of these biomarkers in young children. Methods Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated. Results Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery. Conclusion It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.http://www.e-cep.org/upload/pdf/cep-2019-00913.pdfbiomarkersacute kidney injurycardiac surgerychild |
| spellingShingle | Hee Sun Baek Youngok Lee Hea Min Jang Joonyong Cho Myung Chul Hyun Yeo Hyang Kim Su-Kyeong Hwang Min Hyun Cho Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery Clinical and Experimental Pediatrics biomarkers acute kidney injury cardiac surgery child |
| title | Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery |
| title_full | Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery |
| title_fullStr | Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery |
| title_full_unstemmed | Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery |
| title_short | Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery |
| title_sort | variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery |
| topic | biomarkers acute kidney injury cardiac surgery child |
| url | http://www.e-cep.org/upload/pdf/cep-2019-00913.pdf |
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