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Comparative Study
Comparative analysis of urinary biomarkers for early detection of acute kidney injury following cardiopulmonary bypass.
- Orfeas Liangos, Hocine Tighiouart, Mary C Perianayagam, Alexey Kolyada, Won K Han, Ron Wald, Joseph V Bonventre, and Bertrand L Jaber.
- Division of Nephrology, Caritas St Elizabeth's Medical Center, Boston, MA 02135, USA.
- Biomarkers. 2009 Sep 1;14(6):423-31.
AbstractThe purpose of this study was to compare the performance of six candidate urinary biomarkers, kidney injury molecule (KIM)-1, N-acetyl-beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-18, cystatin C and alpha-1 microglobulin, measured 2 h following cardiopulmonary bypass (CPB) for the early detection of acute kidney injury (AKI) in a prospective cohort of patients undergoing cardiac surgery. A total of 103 subjects were enrolled; AKI developed in 13%. Urinary KIM-1 achieved the highest area under-the-receiver-operator-characteristic curve (AUC 0.78, 95% confidence interval 0.64-0.91), followed by IL-18 and NAG. Only urinary KIM-1 remained independently associated with AKI after adjustment for a preoperative AKI prediction score (Cleveland Clinic Foundation score; p = 0.02), or CPB perfusion time (p = 0.006). In this small pilot cohort, KIM-1 performed best as an early biomarker for AKI. Larger studies are needed to explore further the role of biomarkers for early detection of AKI following cardiac surgery.
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