Urinary aprotinin as a predictor of acute kidney injury after cardiac surgery in children receiving aprotinin therapy
| Autor: | Gary F. Ross, Mai T. Nguyen, Nathan Harris, Catherine L. Dent, Peter B. Manning, Mark Mitsnefes, Prasad Devarajan |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Urinary system Urology Sensitivity and Specificity Hemostatics law.invention chemistry.chemical_compound Aprotinin Postoperative Complications Predictive Value of Tests Risk Factors law Internal medicine Cardiopulmonary bypass medicine Humans Child Creatinine Cardiopulmonary Bypass business.industry Infant Newborn Area under the curve Acute kidney injury Infant Acute Kidney Injury medicine.disease ROC Curve chemistry Child Preschool Anesthesia Pediatrics Perinatology and Child Health Biomarker (medicine) Female business Biomarkers medicine.drug |
| Zdroj: | Pediatric Nephrology. 23:1317-1326 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s00467-008-0827-9 |
| Popis: | Proteomic analysis has revealed potential early biomarkers of acute kidney injury (AKI) in children undergoing cardiopulmonary bypass (CPB), the most prominent one with a mass-to-charge ratio of 6.4 kDa. The objective of this study was to identify this protein and test its utility as a biomarker of AKI. Trypsin-digested protein bands were analyzed by tandem mass spectrometry (MS/MS) to identify the protein in urine samples. Surface-enhanced laser desorption/ionization time-of-flight analysis and a functional activity assay were performed to quantify urinary levels in a pilot study of 106 pediatric patients undergoing CPB. The protein was identified as aprotinin. Urinary aprotinin levels 2 h after initiation of CPB were predictive of AKI (for functional assay: 92% sensitivity, 96% specificity, area under the curve of 0.98). By multivariate analysis, the urinary aprotinin level 2 h after CPB was an independent predictor of AKI (beta = 0.001, P0.0001). The 2 h urinary aprotinin level correlated with serum creatinine, duration of AKI, and length of hospital stay. We concluded that urinary aprotinin levels 2 h after initiation of CPB predict the development of AKI and adverse clinical outcomes. |
| Databáze: | OpenAIRE |
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