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Neutrophil gelatinase-associated lipocalin concentrations predict development of acute kidney injury in neonates and children after cardiopulmonary bypass.
Krawczeski, Catherine D; Woo, Jessica G; Wang, Yu; Bennett, Michael R; Ma, Qing; Devarajan, Prasad.
Afiliação
  • Krawczeski CD; Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. catherine.krawczeski@cchmc.org
J Pediatr ; 158(6): 1009-1015.e1, 2011 Jun.
Article em En | MEDLINE | ID: mdl-21300375
OBJECTIVES: To investigate neutrophil gelatinase-associated lipocalin (NGAL) as an early acute kidney injury (AKI) biomarker after neonatal and pediatric cardiopulmonary bypass (CPB). STUDY DESIGN: Serum and urine samples were obtained before and at intervals after CPB from 374 patients. AKI was defined as a serum creatinine (S(Cr)) concentration increase from baseline ≥0.3 mg/dL in neonates and ≥50% in children within 48 hours of CPB. Logistic regression was used to assess predictors and clinical outcomes associated with AKI. RESULTS: AKI developed in 30% of patients. Plasma and urine NGAL thresholds significantly increased in patients with AKI at 2 hours after CPB and remained elevated at all points, with 2-hour NGAL the earliest, strongest predictor of AKI. In non-neonates, 2-hour plasma and urine NGAL thresholds strongly correlated with length of hospital stay and severity and duration of AKI. CONCLUSION: Plasma and urine NGAL thresholds are early predictive biomarkers for AKI and its clinical outcomes after CPB. In neonates, we recommend a 2-hour plasma NGAL threshold of 100 ng/mL and 2-hour urine NGAL threshold of 185 ng/mL for diagnosis of AKI. In non-neonates, recommended AKI thresholds are 50 ng/mL for both 2-hour plasma and urine NGAL.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Proteínas de Fase Aguda / Proteínas Proto-Oncogênicas / Lipocalinas / Injúria Renal Aguda / Insuficiência Cardíaca Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Proteínas de Fase Aguda / Proteínas Proto-Oncogênicas / Lipocalinas / Injúria Renal Aguda / Insuficiência Cardíaca Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos