• Özgün Uygur, KöroğluÖzge AltunÖADepartment of Pediatrics, Faculty of Medicine, Ege University İzmir, Turkey., Reşit Ertürk Levent, Eser Sözmen, Fırat Ergin, Yüksel Atay, Mehmet Yalaz, Mete Akısü, and Nilgün Kültürsay.
• Department of Pediatrics, Faculty of Medicine, Ege University İzmir, Turkey.
• Turk J Med Sci. 2021 Feb 1; 51 (1): 175180175-180.

BackgroundCongenital heart disease (CHD) is the most common congenital malformation group and is the leading cause of newborn mortality in developed countries. Most of the infants with CHD develop preoperative or postoperative acute kidney injury (AKI). Acute kidney injury may develop before the serum creatinine rise and oliguria. Urinary biomarkers such as kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-18, and cystatin C may predict AKI in patients with critical CHD (CCHD) before the serum creatinine rise. In this study, we aimed to determine the AKI incidence among newborn patients with CCHD and investigate the predictivity of urinary biomarkers for AKI.MethodsNewborns with a gestational age >34 weeks and birth weight >1500 g with a diagnosis of CCHD were enrolled in the study. Blood and urine samples were collected at birth, during the first 24-48 h, and in the preoperative and postoperative periods.ResultsA total of 53 CCHD patients requiring surgery during the neonatal period were enrolled in the study. The 24-48 h KIM-1 levels of the cases with exitus were higher (P = 0.007). The 24-48 h cystatin C and preoperative NGAL levels were higher in patients with postoperative AKI (P = 0.02).DiscussionIn newborns with CCHD, high KIM-1 levels may predict mortality, whereas high cystatin C and preoperative NGAL levels may be indicative of AKI. These biomarkers deserve further investigation in larger study populations.

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