Urine dipstick blood and acute kidney injury in infants undergoing cardiopulmonary bypass.

Autor: Strong AE; Division of Nephrology, Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA. amy-strong@uiowa.edu.; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. amy-strong@uiowa.edu., Zee J; Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, USA.; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA., Laskin BL; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA., Howarth K; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Blinder J; Division of Cardiology, Stanford Medicine Children's Health, Palo Alto, CA, USA., Chrischilles EA; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA., Erez DL; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Schneider Children's Medical Center of Israel, Petah Tikva, Israel.; School of Medicine, Tel Aviv University, Tel Aviv, Israel., Denburg MR; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Dec; Vol. 39 (12), pp. 3591-3596. Date of Electronic Publication: 2024 Aug 02.
DOI: 10.1007/s00467-024-06464-9
Abstrakt: Background: Cardiopulmonary bypass (CPB) is associated with hemolysis and acute kidney injury (AKI). The study aim was to determine if urine dipstick blood in infants after CPB was associated with AKI and urine neutrophil gelatinase-associated lipocalin (NGAL).
Methods: Infants who underwent CPB at a single center were enrolled prospectively between October 2017 and June 2019. Urine samples prior to CPB and 6 h after CPB cessation were analyzed in batch for NGAL and dipstick blood. AKI was defined using creatinine-based KDIGO criteria within 72 h of CPB. Spearman correlation examined associations between urine dipstick blood and NGAL at each time point. Linear regression estimated the associations between urine dipstick blood and log-transformed NGAL 6 h after CPB. Logistic regression estimated associations and compared discrimination between urine dipstick blood and NGAL for predicting AKI.
Results: At baseline, 7/63 samples (11%) had > trace blood. Six hours after CPB, 62/98 samples (63%) had > trace blood and 26% had 3 + (large) blood. In total, 18/98 (18%) with a 6-h post-CPB sample had postoperative AKI. Urine dipstick blood values correlated with urine NGAL 6 h after CPB (r = 0.52, p < 0.01), but not at baseline (r = 0.06, p = 0.66). Those with 3 + (large) blood on urine dipstick had 6 times higher mean NGAL values compared to those with negative/trace blood (mean ratio 6.6, 95%CI 3.1-14.4, p < 0.01). Those with 3 + (large) blood had 8 times higher odds of AKI (OR 7.99, 95%CI 1.5-41.9, p = 0.01).
Conclusions: Urine dipstick blood post CPB may be a simple and inexpensive tool to help predict AKI in infants.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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