Comparative analysis of urinary biomarkers for early detection of acute kidney injury following cardiopulmonary bypass |
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| Authors: | Orfeas Liangos Hocine Tighiouart Mary C Perianayagam Alexey Kolyada Won K Han Ron Wald |
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| Institution: | 1. Division of Nephrology, Caritas St Elizabeth’s Medical Center, Boston, MA, USA;2. Biostatistics Research Center, Tufts Medical Center, Boston, MA, USA;3. Renal Division, Brigham and Women’s Hospital, Boston, MA, USA;4. Division of Nephrology, St Michael’s Hospital, Toronto, Ontario, Canada |
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| Abstract: | The purpose of this study was to compare the performance of six candidate urinary biomarkers, kidney injury molecule (KIM)-1, N-acetyl-β-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-18, cystatin C and α-1 microglobulin, measured 2?h following cardiopulmonary bypass (CPB) for the early detection of acute kidney injury (AKI) in a prospective cohort of patients undergoing cardiac surgery. A total of 103 subjects were enrolled; AKI developed in 13%. Urinary KIM-1 achieved the highest area under-the-receiver-operator-characteristic curve (AUC 0.78, 95% confidence interval 0.64–0.91), followed by IL-18 and NAG. Only urinary KIM-1 remained independently associated with AKI after adjustment for a preoperative AKI prediction score (Cleveland Clinic Foundation score; p?=?0.02), or CPB perfusion time (p?=?0.006). In this small pilot cohort, KIM-1 performed best as an early biomarker for AKI. Larger studies are needed to explore further the role of biomarkers for early detection of AKI following cardiac surgery. |
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| Keywords: | Acute kidney injury early detection urinary biomarker cardiac surgery |
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