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Cited by 332

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Temporal Relationship and Predictive Value of Urinary Acute Kidney Injury Biomarkers After Pediatric Cardiopulmonary Bypass

Open access
Krawczeski, Catherine D., Goldstein, Stuart L., Woo, Jessica G., Wang, Yu, Piyaphanee, Nuntawan, Ma, Qing, Bennett, Michael, Devarajan, Prasad·2011·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2011.08.017
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Abstract

Objectives We investigated the temporal pattern and predictive value (alone and in combination) of four urinary biomarkers [neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), liver fatty-acid binding protein (L-FABP) and kidney injury molecule-1 (KIM-1)] for cardiac surgery-associated acute kidney injury (AKI). Background Serum creatinine (SCr) is a delayed marker for AKI after cardiopulmonary bypass (CPB). Rapidly detectable AKI biomarkers could allow early intervention and improve outcomes. Methods Data from 220 pediatric patients were analyzed. Urine samples were obtained before and at intervals after CPB initiation. AKI was defined as a ≥50% increase in SCr from baseline within 48h after CPB. The temporal pattern of biomarker elevation was established and biomarker elevations were correlated with AKI severity and clinical outcomes. Biomarker predictive abilities were evaluated by AUC, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results AKI occurred in 27% of patients. Urine NGAL significantly increased in AKI patients at 2h after CPB initiation. IL-18 and L-FABP increased at 6h and KIM-1 increased at 12h. Biomarker elevations correlated with AKI severity and clinical outcomes, and improved AKI prediction above a clinical model. At 2h, addition of NGAL increased the AUC from 0.74 to 0.85 (p<0.0001). At 6h, NGAL, IL-18 and L-FABP each improved the AUC from 0.72 to 0.91, 0.84 and 0.77, respectively (all p<0.05). The added predictive ability of the biomarkers was supported by NRI and IDI. Biomarker combinations further improved AKI prediction. Conclusion Urine NGAL, IL-18, L-FABP, and KIM-1 are sequential predictive biomarkers for AKI and correlate with disease severity and clinical outcomes after pediatric CPB. These biomarkers, particularly in combination, may help establish the timing of injury and allow earlier intervention in AKI.

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Metadata

Authors
Krawczeski, C. D., Goldstein, S. L., Woo, J. G., Wang, Y., Piyaphanee, N., Ma, Q., Bennett, M., & Devarajan, P.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2011-11
Volume
58
Issue
22
Pages
2301-2309
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2011.08.017
OpenAlex
W2024433016
Cited by
332
References
28
FWCI
20.61
Type
journal article
Language
en
Open access
bronze

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The paper
Krawczeski, C. D., Goldstein, S. L., Woo, J. G., Wang, Y., Piyaphanee, N., Ma, Q., Bennett, M., & Devarajan, P. (2011). Temporal Relationship and Predictive Value of Urinary Acute Kidney Injury Biomarkers After Pediatric Cardiopulmonary Bypass. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2011.08.017

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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