BACKGROUND: Acute kidney injury (AKI) is a common postoperative complication following cardiopulmonary bypass (CPB) surgery. New biomarkers to identify patients with early AKI (before increases in serum creatinine) are needed to facilitate appropriate treatment. This study aimed to test the role of urinary liver fatty-acid-binding protein (L-FABP) as an early biomarker for AKI in children undergoing CPB surgery. METHODS: This is a case-control study of children undergoing CPB. AKI was defined as 50 % increase in serum creatinine at 48 h after surgery. For each patient, five serum and urine samples were obtained corresponding to time 0 h (presurgery) and 2, 6, 24, and 48 h after surgery. RESULTS: Twenty-seven patients, median age 360 days, were enrolled. AKI developed in 11 patients (41 %); three needed renal replacement therapy (peritoneal dialysis); there were two deaths. There were significant differences between patients with and without AKI in L-FABP levels at 2, 6, and 48 h after surgery, length of hospital stay, and CPB time; there were no differences in gender, patient age, and body weight. L-FABP was normalized to urinary creatinine concentration at all time points, with area under the receiver operator curve (AUC ROC) 0.867 at 2 and 6 h postoperatively. Correlation coefficient between L-FABP and length of hospital stay after surgery was statistically significant (r = 0.722, p value = 0.000). CONCLUSIONS: Our results suggest that urinary L-FABP can be used to diagnose AKI earlier than rise in serum creatinine in children undergoing CPB.
BACKGROUND:Acute kidney injury (AKI) is a common postoperative complication following cardiopulmonary bypass (CPB) surgery. New biomarkers to identify patients with early AKI (before increases in serum creatinine) are needed to facilitate appropriate treatment. This study aimed to test the role of urinary liver fatty-acid-binding protein (L-FABP) as an early biomarker for AKI in children undergoing CPB surgery. METHODS: This is a case-control study of children undergoing CPB. AKI was defined as 50 % increase in serum creatinine at 48 h after surgery. For each patient, five serum and urine samples were obtained corresponding to time 0 h (presurgery) and 2, 6, 24, and 48 h after surgery. RESULTS: Twenty-seven patients, median age 360 days, were enrolled. AKI developed in 11 patients (41 %); three needed renal replacement therapy (peritoneal dialysis); there were two deaths. There were significant differences between patients with and without AKI in L-FABP levels at 2, 6, and 48 h after surgery, length of hospital stay, and CPB time; there were no differences in gender, patient age, and body weight. L-FABP was normalized to urinary creatinine concentration at all time points, with area under the receiver operator curve (AUC ROC) 0.867 at 2 and 6 h postoperatively. Correlation coefficient between L-FABP and length of hospital stay after surgery was statistically significant (r = 0.722, p value = 0.000). CONCLUSIONS: Our results suggest that urinary L-FABP can be used to diagnose AKI earlier than rise in serum creatinine in children undergoing CPB.
Authors: John R Prowle; Yan-Lun Liu; Elisa Licari; Sean M Bagshaw; Moritoki Egi; Michael Haase; Anja Haase-Fielitz; John A Kellum; Dinna Cruz; Claudio Ronco; Kenji Tsutsui; Shigehiko Uchino; Rinaldo Bellomo Journal: Crit Care Date: 2011-07-19 Impact factor: 9.097
Authors: Ravindra L Mehta; John A Kellum; Sudhir V Shah; Bruce A Molitoris; Claudio Ronco; David G Warnock; Adeera Levin Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Catherine L Dent; Qing Ma; Sudha Dastrala; Michael Bennett; Mark M Mitsnefes; Jonathan Barasch; Prasad Devarajan Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Ana Flávia Lima Ruas; Gabriel Malheiros Lébeis; Nicholas Bianco de Castro; Vitória Andrade Palmeira; Larissa Braga Costa; Katharina Lanza; Ana Cristina Simões E Silva Journal: Pediatr Nephrol Date: 2021-11-30 Impact factor: 3.651
Authors: Joycilene da Silva Barbosa; Geraldo Bezerra da Silva Júnior; Gdayllon Cavalcante Meneses; Alice Maria Costa Martins; Elizabeth De Francesco Daher; Rosângela Pinheiro Gonçalves Machado; Romélia Pinheiro Gonçalves Lemes Journal: J Bras Nefrol Date: 2022 Jan-Mar