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Urine microscopy as a biomarker of Acute Kidney Injury following cardiac surgery with cardiopulmonary bypass.
Goldani, João Carlos; Poloni, José Antônio; Klaus, Fabiano; Kist, Roger; Pacheco, Larissa Sgaria; Keitel, Elizete.
Afiliação
  • Goldani JC; Departamento de Nefrologia, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
  • Poloni JA; Laboratório de Análises Clínicas Carlos Franco Voegeli, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
  • Klaus F; Departamento de Nefrologia, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
  • Kist R; Departamento de Nefrologia, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
  • Pacheco LS; Departamento de Nefrologia, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
  • Keitel E; Departamento de Nefrologia, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
J Bras Nefrol ; 42(1): 18-23, 2020 Mar.
Article em Pt, En | MEDLINE | ID: mdl-31638137
INTRODUCTION: Acute kidney injury (AKI) occurs in about 22% of the patients undergoing cardiac surgery and 2.3% requires renal replacement therapy (RRT). The current diagnostic criteria for AKI by increased serum creatinine levels have limitations and new biomarkers are being tested. Urine sediment may be considered a biomarker and it can help to differentiate pre-renal (functional) from renal (intrinsic) AKI. AIMS: To investigate the microscopic urinalysis in the AKI diagnosis in patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: One hundred and fourteen patients, mean age 62.3 years, 67.5 % male, with creatinine 0.91 mg/dL (SD 0.22) had a urine sample examined in the first 24 h after the surgery. We looked for renal tubular epithelial cells (RTEC) and granular casts (GC) and associated the results with AKI development as defined by KDIGO criteria. RESULTS: Twenty three patients (20.17 %) developed AKI according to the serum creatinine criterion and 76 (66.67 %) by the urine output criterion. Four patients required RRT. Mortality was 3.51 %. The use of urine creatinine criterion to predict AKI showed a sensitivity of 34.78 % and specificity of 86.81 %, positive likelihood ratio of 2.64 and negative likelihood ratio of 0.75, AUC-ROC of 0.584 (95%CI: 0.445-0.723). For the urine output criterion sensitivity was 23.68 % and specificity 92.11 %, AUC-ROC was 0.573 (95%CI: 0.465-0.680). CONCLUSION: RTEC and GC in urine sample detected by microscopy is a highly specific biomarker for early AKI diagnosis after cardiac surgery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Ponte Cardiopulmonar / Células Epiteliais / Injúria Renal Aguda / Procedimentos Cirúrgicos Cardíacos / Túbulos Renais Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En / Pt Revista: J Bras Nefrol Assunto da revista: NEFROLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Ponte Cardiopulmonar / Células Epiteliais / Injúria Renal Aguda / Procedimentos Cirúrgicos Cardíacos / Túbulos Renais Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En / Pt Revista: J Bras Nefrol Assunto da revista: NEFROLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil