Author + information
- David S. Cooper,
- Donna Claes,
- Stuart L. Goldstein,
- Shina Menon,
- Michael Bennett,
- Qing Ma and
- Catherine Krawczeski
Novel urinary biomarkers predict acute kidney injury (AKI) after cardiopulmonary bypass (CPB-AKI). AKI increases risk for future chronic kidney disease (CKD) in adults. We aimed to determine if urinary biomarkers remained chronically elevated in patients (pts) with CPB-AKI (AKI+) vs. without AKI (AKI-).
We compared CKD clinical/laboratory markers (urine microalbumin/Cr, Schwartz eGFR and blood pressure) and novel urinary biomarkers (uNGAL, uIL-18, uKIM-1 & uL-FABP) in AKI+ (n=19) versus AKI- (n=12) pts 6.8+/− 0.8 yrs (mean) post-CPB. CPB-AKI was defined by the pRIFLE criteria (≥ 50% increase in serum creatinine (sCr) over baseline).
Baseline characteristics between AKI + versus AKI - pts were similar (RACHS-1, CPB time, age at surgery) except for peak sCR (median 0.77 vs 0.48 mg/dL; p=0.02). At follow-up, both cohorts had similar age (7.9 +/− 1.5 vs 7.7 +/− 0.35 yrs). Clinical/laboratory CKD markers were normal in the majority of pts and did not differ between the groups. Urinary biomarker concentrations for AKI + versus AKI - pts are presented in the Table.
In this long term follow-up of children post CPB, we observed 1) persistently elevated uIL-18, uKIM-1 and uL-FABP in AKI + patients, 2) higher uIL-18, uKIM-1 and uL-FABP in AKI + versus AKI - pts and 3) no evidence of classic CKD signs. We suggest novel urinary biomarkers could serve as a more sensitive marker of chronic kidney injury in children who develop post-CPB AKI.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Cardiology Solutions: Surgical Outcomes
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1118-126
- 2013 American College of Cardiology Foundation