title: Comparative analysis of urinary biomarkers for early detection of acute kidney injury following cardiopulmonary bypass.
abstract: The purpose of this study was to compare the performance of six candidate urinary biomarkers, kidney injury molecule (KIM)-1, N-acetyl-beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-18, cystatin C and alpha-1 microglobulin, measured 2 h following cardiopulmonary bypass (CPB) for the early detection of acute kidney injury (AKI) in a prospective cohort of patients undergoing cardiac surgery. A total of 103 subjects were enrolled; AKI developed in 13%. Urinary KIM-1 achieved the highest area under-the-receiver-operator-characteristic curve (AUC 0.78, 95% confidence interval 0.64-0.91), followed by IL-18 and NAG. Only urinary KIM-1 remained independently associated with AKI after adjustment for a preoperative AKI prediction score (Cleveland Clinic Foundation score; p = 0.02), or CPB perfusion time (p = 0.006). In this small pilot cohort, KIM-1 performed best as an early biomarker for AKI. Larger studies are needed to explore further the role of biomarkers for early detection of AKI following cardiac surgery.
authors: Division of Nephrology, Caritas St Elizabeth's Medical Center, Boston, MA 02135, USA.
authors: Orfeas
authors: O
authors: Liangos
authors: Hocine
authors: H
authors: Tighiouart
authors: Mary C
authors: MC
authors: Perianayagam
authors: Alexey
authors: A
authors: Kolyada
authors: Won K
authors: WK
authors: Han
authors: Ron
authors: R
authors: Wald
authors: Joseph V
authors: JV
authors: Bonventre
authors: Bertrand L
authors: BL
authors: Jaber
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology; D000209:Acute-Phase Proteins / Q000652:urine; D015415:Biomarkers / Q000652:urine; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D015331:Cohort Studies; D055316:Cystatin C / Q000652:urine; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D020382:Interleukin-18 / Q000652:urine; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008562:Membrane Glycoproteins / Q000652:urine*; D011183:Postoperative Complications / Q000175:diagnosis / Q000652:urine; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine; D011991:Receptors, Virus; D000511:alpha-Macroglobulins / Q000652:urine
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D000511:alpha-Macroglobulins