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

Abadeer, Maher ; Swartz, Michael F. ; Martin, Susan D. ; Groves, Angela M. ; Kent, Alison L. ; Schwartz, George J. ; Brophy, Patrick ; Alfieris, George M. ; Cholette, Jill M.

Pediatric cardiology, 2023-04, Vol.44 (4), p.855-866 [Periódico revisado por pares]

New York: Springer US

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Título:
Using Serum Cystatin C to Predict Acute Kidney Injury Following Infant Cardiac Surgery
Autor: Abadeer, Maher ; Swartz, Michael F. ; Martin, Susan D. ; Groves, Angela M. ; Kent, Alison L. ; Schwartz, George J. ; Brophy, Patrick ; Alfieris, George M. ; Cholette, Jill M.
Assuntos: Acute Kidney Injury - diagnosis ; Acute Kidney Injury - etiology ; Analysis ; Biomarkers ; Cardiac Surgery ; Cardiac Surgical Procedures - adverse effects ; Cardiology ; Cardiopulmonary Bypass - adverse effects ; Coronary artery bypass ; Creatinine ; Cystatin C ; Health aspects ; Humans ; Infant ; Kidney diseases ; Medicine ; Medicine & Public Health ; Mortality ; Pediatric cardiology ; Prospective Studies ; Surgery ; Tranexamic acid ; Vascular Surgery
É parte de: Pediatric cardiology, 2023-04, Vol.44 (4), p.855-866
Descrição: 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. Prospective observational study of infants (< 1 year) requiring CPB during cardiac surgery. CysC was measured at baseline and 12, 24, 48, and 72 h following CPB initiation. Each post-op percent difference in CysC (e.g. %CysC 12h ) 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. 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 %CysC 12h 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 %CysC 12h was independently associated with AKI. Despite a significant difference in the %CysC 12h , 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.
Editor: New York: Springer US
Idioma: Inglês

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

Abadeer, Maher ; Swartz, Michael F. ; Martin, Susan D. ; Groves, Angela M. ; Kent, Alison L. ; Schwartz, George J. ; Brophy, Patrick ; Alfieris, George M. ; Cholette, Jill M.

New York: Springer US

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