title: Usefulness of urinary biomarkers in early detection of acute kidney injury after cardiac surgery in adults.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common complication after cardiac surgery. Urinary liver-type fatty acid-binding protein (L-FABP) reflects the presence of renal tubular injury. The aim of the present study was to evaluate the utility of urinary L-FABP compared with other urinary biomarkers for the early detection of postoperative AKI among adult patients undergoing cardiac surgery.
  
  
  RESULTS
  Patients were divided into the AKI (n=48) and non-AKI groups (n=37) according to whether they developed postoperative AKI within 48h after surgery. Changes in various biomarkers were evaluated. Urine and serum samples were obtained from each patient at the following time points: before the operation, immediately after the operation, and 3, 6, 18, 24, and 48h postoperatively. The urinary L-FABP level was significantly higher in the AKI group than in the non-AKI group at every time point, while other biomarkers did not show such a tendency. The biomarker with the largest area under the curve at every time point for predicting the onset of AKI was urinary L-FABP. On multiple logistic regression analysis, the urinary L-FABP level before operation and within the first 6h after cardiac surgery was significantly associated with the onset of AKI.
  
  
  CONCLUSIONS
  Urinary L-FABP is a useful biomarker for early detection of AKI and is a good early predictor of the onset of AKI.
authors.affiliation: Department of Nephrology and Hypertension, Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Matsui
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kamijo-Ikemori
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugaya
authors.forename: Takashi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013903:Thoracic Surgery; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins