دورية أكاديمية
أعرض في EDS

Association of Urine Biomarkers With Acute Kidney Injury and Fluid Overload in Infants After Cardiac Surgery: A Single Center Ancillary Cohort of the Steroids to Reduce Systemic Inflammation After Infant Heart Surgery Trial.

التفاصيل البيبلوغرافية
العنوان: Association of Urine Biomarkers With Acute Kidney Injury and Fluid Overload in Infants After Cardiac Surgery: A Single Center Ancillary Cohort of the Steroids to Reduce Systemic Inflammation After Infant Heart Surgery Trial.
المؤلفون: Thompson EJ; Department of Pediatrics, Duke University, Durham, NC.; Duke Clinical Research Institute, Durham, NC., Chamberlain RC; Department of Pediatrics, Duke University, Durham, NC., Hill KD; Department of Pediatrics, Duke University, Durham, NC.; Duke Clinical Research Institute, Durham, NC., Sullenger RD; Duke University School of Medicine, Durham, NC., Graham EM; Department of Pediatrics, Medical University of South Carolina, Charleston, SC., Gbadegesin RA; Department of Pediatrics, Duke University, Durham, NC., Hornik CP; Department of Pediatrics, Duke University, Durham, NC.; Duke Clinical Research Institute, Durham, NC.
المصدر: Critical care explorations [Crit Care Explor] 2023 May 01; Vol. 5 (5), pp. e0910. Date of Electronic Publication: 2023 May 01 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]-
مستخلص: To examine the association between three perioperative urine biomarker concentrations (urine cystatin C [uCysC], urine neutrophil gelatinase-associated lipocalin [uNGAL], and urine kidney injury molecule 1 [uKIM-1]), and cardiac surgery-associated acute kidney injury (CS-AKI) and fluid overload (FO) in infants with congenital heart disease undergoing surgery on cardiopulmonary bypass. To explore how urine biomarkers are associated with distinct CS-AKI phenotypes based on FO status.
Design: Ancillary prospective cohort study.
Setting: Single U.S. pediatric cardiac ICU.
Patients: Infants less than 1 year old enrolled in the Steroids to Reduce Systemic Inflammation after Infant Heart Surgery trial (NCT03229538) who underwent heart surgery from June 2019 to May 2020 and opted into biomarker collection at a single center. Infants with preoperative CS-AKI were excluded.
Interventions: None.
Measurements and Main Results: Forty infants met inclusion criteria. Median (interquartile) age at surgery was 103 days (5.5-161 d). Modified Kidney Disease Improving Global Outcomes-defined CS-AKI was diagnosed in 22 (55%) infants and 21 (53%) developed FO. UCysC and uNGAL peaked in the early postoperative period and uKIM-1 peaked later. In unadjusted analysis, bypass time was longer, and Vasoactive-Inotropic Score at 24 hours was higher in infants with CS-AKI. On multivariable analysis, higher uCysC (odds ratio [OR], 1.023; 95% CI, 1.004-1.042) and uNGAL (OR, 1.019; 95% CI, 1.004-1.035) at 0-8 hours post-bypass were associated with FO. UCysC, uNGAL, and uKIM-1 did not significantly correlate with CS-AKI. In exploratory analyses of CS-AKI phenotypes, uCysC and uNGAL were highest in CS-AKI+/FO+ infants.
Conclusions: In this study, uCysC and uNGAL in the early postoperative period were associated with FO at 48 hours. UCysC, uNGAL, and uKIM-1 were not associated with CS-AKI. Further studies should focus on defining expected concentrations of these biomarkers, exploring CS-AKI phenotypes and outcomes, and establishing clinically meaningful endpoints for infants post-cardiac surgery.
Competing Interests: Dr. Thompson was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number T32HD104576. Dr. Hill reports support from the National Centers for Advancing Translational Sciences (U01TR-001803-01). The remaining authors have disclosed that they do not have any potential conflicts of interest.
(Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
References: Pediatr Crit Care Med. 2016 May;17(5):420-7. (PMID: 27028790)
Ther Drug Monit. 2018 Apr;40(2):186-194. (PMID: 29529007)
J Intensive Care. 2017 Jul 20;5:49. (PMID: 28729908)
Curr Treat Options Pediatr. 2019 Dec;5(4):326-342. (PMID: 33282633)
Arch Acad Emerg Med. 2020 Apr 05;8(1):e44. (PMID: 32309808)
Crit Care Med. 2011 Jun;39(6):1493-9. (PMID: 21336114)
Pediatr Crit Care Med. 2016 Apr;17(4):307-14. (PMID: 26914622)
J Thorac Cardiovasc Surg. 2012 Feb;143(2):368-74. (PMID: 21798562)
Pediatr Nephrol. 2018 Mar;33(3):511-520. (PMID: 29128923)
Curr Opin Crit Care. 2022 Dec 1;28(6):590-598. (PMID: 36044290)
Pediatr Crit Care Med. 2014 Feb;15(2):121-30. (PMID: 24366512)
Am Heart J. 2002 Jan;143(1):15-21. (PMID: 11773907)
N Engl J Med. 2022 Dec 8;387(23):2138-2149. (PMID: 36342116)
Kidney Int. 2010 Sep;78(5):486-94. (PMID: 20555318)
Pediatr Crit Care Med. 2010 Mar;11(2):234-8. (PMID: 19794327)
Crit Care Med. 2014 Dec;42(12):2591-9. (PMID: 25072753)
Nephron Physiol. 2005;99(1):p10-5. (PMID: 15637467)
J Pediatr. 2011 Jun;158(6):1009-1015.e1. (PMID: 21300375)
Clin Biochem. 2013 Sep;46(13-14):1244-51. (PMID: 23876402)
Am Heart J. 2020 Feb;220:192-202. (PMID: 31855716)
Am J Perinatol. 2014 Oct;31(9):773-80. (PMID: 24623338)
Clin Exp Pediatr. 2020 Apr;63(4):151-156. (PMID: 32023398)
JAMA Netw Open. 2022 Sep 1;5(9):e2229442. (PMID: 36178697)
Pediatr Crit Care Med. 2013 Jan;14(1):44-9. (PMID: 23249789)
Semin Thorac Cardiovasc Surg. 2023 Spring;35(1):140-147. (PMID: 35176496)
Cardiol Young. 2018 Feb;28(2):243-251. (PMID: 28889829)
J Am Soc Nephrol. 2012 Feb;23(2):322-33. (PMID: 22095948)
Crit Care. 2020 Apr 21;24(1):164. (PMID: 32316994)
Pediatr Crit Care Med. 2013 Jun;14(5):e218-24. (PMID: 23439467)
Nephrology (Carlton). 2019 Mar;24(3):294-300. (PMID: 29451341)
Pediatr Crit Care Med. 2014 Feb;15(2):131-8. (PMID: 24366508)
Am J Kidney Dis. 2013 May;61(5):730-8. (PMID: 23332602)
Turk J Med Sci. 2021 Feb;51(1):175-180. (PMID: 33021763)
Ann Thorac Surg. 2022 Dec;114(6):2288-2294. (PMID: 35245511)
World J Pediatr Surg. 2020 Jun 25;3(2):e000107. (PMID: 36474915)
Pediatr Crit Care Med. 2020 Feb;21(2):170-177. (PMID: 31568240)
Crit Care Med. 2021 Oct 1;49(10):e941-e951. (PMID: 34166288)
Pediatr Neonatol. 2019 Feb;60(1):3-11. (PMID: 29891225)
Pediatr Cardiol. 2020 Apr;41(4):695-702. (PMID: 31872282)
معلومات مُعتمدة: T32 GM086330 United States GM NIGMS NIH HHS; T32 HD104576 United States HD NICHD NIH HHS
فهرسة مساهمة: Keywords: acute kidney injury; fluid overload; infants; post-cardiac surgery; urine biomarkers
تواريخ الأحداث: Date Created: 20230508 Latest Revision: 20230915
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10155890
DOI: 10.1097/CCE.0000000000000910
PMID: 37151894
قاعدة البيانات: MEDLINE
الوصف
تدمد:2639-8028
DOI:10.1097/CCE.0000000000000910