Using Serum Cystatin C to Predict Acute Kidney Injury Following Infant Cardiac Surgery

Autor: Maher Abadeer, Michael F. Swartz, Susan D. Martin, Alison L. Kent, George J. Schwartz, Patrick Brophy, George M. Alfieris, Jill M. Cholette, Angela M. Groves
Rok vydání: 2023
Předmět:
Zdroj: Pediatric Cardiology. 44:855-866
ISSN: 1432-1971
0172-0643
DOI: 10.1007/s00246-022-03080-y
Popis: Background: Acute kidney injury (AKI) following cardiopulmonary bypass (CPB) is associated with increased morbidity and mortality. Serum Cystatin C (CysC) is a novel biomarker synthesized by all nucleated cells that may act as an early indicator of AKI following infant CPB. Methods: Prospective observational study of infants (< 1 year) requiring CPB during cardiac surgery. CysC was measured at baseline and 12, 24, 48, and 72 hours following CPB initiation. Each post-op percent difference in CysC (e.g. %CysC12hr) from baseline was calculated. Clinical variables along with urine output (UOP) and serum creatinine (SCr) were followed. Subjects were divided into two groups: AKI and non-AKI based upon the Kidney Disease Improving Global Outcomes (KDIGO) classification. Results: AKI occurred in 41.9% (18) of the 43 infants enrolled. Patient demographics and baseline CysC levels were similar between groups. CysC levels were 0.97 ± 0.28 mg/L over the study period, and directly correlated with SCr (R = 0.71, p < 0.0001). Although absolute CysC levels were not significant between groups, the %CysC12hr was significantly greater in the AKI group (AKI: -16%±22% vs. Non-AKI -28%±9% mg/L; p=0.003). However, multivariate analysis demonstrated that a lower UOP (Odds Ratio:0.298; 95% CI:0.073, 0.850; p=0.02) but not %CysC12hr was independently associated with AKI. Conclusions: Despite a significant difference in the %CysC12hr, only UOP was independently associated with AKI. Larger studies of a more homogenous population are needed to understand these results and to explore the variability in this biomarker seen across institutions.
Databáze: OpenAIRE
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