Beta-2-microglobulin as an index of renal function after cardiopulmonary bypass surgery in children.
In order to evaluate the clinical usefulness of serum and urinary beta-2-microglobulin (beta 2-m) determination as a marker of renal damage following cardiopulmonary bypass surgery (CPB), 37 children, with an age range of 6 months to 13 years undergoing CPB under hypothermia and cardioplegia for congenital malformations, were studied. Renal function was monitored at baseline and on the first and third day after CPB by traditional tests such as creatinine (Cr), endogenous creatinine clearance (Ccr), and fractional sodium excretion (FeNa), as well as by serum and urinary beta 2-m measured by radioimmunosorbent assay. Data were analyzed for the group as a whole and after stratification for the presence of acute renal failure (ARF) defined by an increase in Cr greater than 0.5 mg/dl and/or FeNa greater than 2% and of renal hypoperfusion which was considered in case of hypotension resistant to volume repletion and/or dopamine infusion and of oliguria (less than 1.0 ml/kg/h). The incidence of ARF was 18.9%, mortality 21.7% and among those who developed ARF, 71.4%. Although Cr and FeNa increased significantly on the first postoperative day, values returned to baseline thereafter, probably because of the high mortality rate observed among those who developed ARF and were therefore lost to follow-up. In contrast, Ccr was significantly decreased during the whole study. Even though serum beta 2-m displayed a similar profile to Cr and FeNa returning to baseline by the third day, urinary and fractional excretion of beta 2-m were significantly increased at any time of the study.(ABSTRACT TRUNCATED AT 250 WORDS)
Fernandez
F
F
Department of Pediatrics, Reina Sofia Hospital, Córdoba, Spain.
de Miguel
M D
MD
Barrio
V
V
Mallol
J
J
D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000652:urine; D000293:Adolescent; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D007677:Kidney Function Tests; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D001613:beta 2-Microglobulin / Q000032:analysis*
D001613:beta 2-Microglobulin