Urinary cystatin C as an early biomarker of acute kidney injury following adult cardiothoracic surgery
| Autor: | Sharon Trevino, Qing Ma, Elaine M. Worcester, Michael O'Connor, Michael R. Bennett, Kristen Kasza, David J. Konczal, Patrick T. Murray, Jai Raman, Valluvan Jeevanandam, Jay L. Koyner, Prasad Devarajan |
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| Rok vydání: | 2008 |
| Předmět: |
Nephrology
medicine.medical_specialty Time Factors medicine.medical_treatment Urinary system 030232 urology & nephrology Urology 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Lipocalin-2 Proto-Oncogene Proteins Internal medicine medicine Prospective Studies Renal replacement therapy Cardiac Surgical Procedures Cystatin C biology business.industry Acute kidney injury medicine.disease Lipocalins 3. Good health Surgery Cardiac surgery acute kidney injury Elective Surgical Procedures Cardiothoracic surgery Neutrophil Gelatinase Associated Lipocalin biology.protein biomarker Kidney Diseases business cardiac surgery Biomarkers Acute-Phase Proteins Kidney disease |
| Zdroj: | Kidney International. 74:1059-1069 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/ki.2008.341 |
| Popis: | There is a need to develop early biomarkers of acute kidney injury following cardiac surgery, where morbidity and mortality are increased by its presence. Plasma cystatin C (CyC) and plasma and urine Neutrophil Gelatinase Associated Lipocalin (NGAL) have been shown to detect kidney injury earlier than changes in plasma creatinine in critically ill patients. In order to determine the utility of urinary CyC levels as a measure of kidney injury, we prospectively collected plasma and urine from 72 adults undergoing elective cardiac surgery for analysis. Acute kidney injury was defined as a 25% or greater increase in plasma creatinine or renal replacement therapy within the first 72 hours following surgery. Plasma CyC and NGAL were not useful predictors of acute kidney injury within the first 6 hours following surgery. In contrast, both urinary CyC and NGAL were elevated in the 34 patients who later developed acute kidney injury, compared to those with no injury. The urinary NGAL at the time of ICU arrival and the urinary CyC level 6 hours after ICU admission were most useful for predicting acute kidney injury. A composite time point consisting of the maximum urinary CyC achieved in the first 6 hours following surgery outperformed all individual time points. Our study suggests that urinary CyC and NGAL are superior to conventional and novel plasma markers in the early diagnosis of acute kidney injury following adult cardiac surgery. |
| Databáze: | OpenAIRE |
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