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Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery

Background We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal i... Full description

Journal Title: Pediatric nephrology (Berlin West), 2018, Vol.33 (6), p.1069-1077
Main Author: Greenberg, Jason H
Other Authors: Devarajan, Prasad , Thiessen-Philbrook, Heather R , Krawczeski, Catherine , Parikh, Chirag R , Zappitelli, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
CKD
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/29511889
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title: Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery
format: Article
creator:
  • Greenberg, Jason H
  • Devarajan, Prasad
  • Thiessen-Philbrook, Heather R
  • Krawczeski, Catherine
  • Parikh, Chirag R
  • Zappitelli, Michael
subjects:
  • acute kidney injury
  • Acute Kidney Injury - complications
  • Acute Kidney Injury - urine
  • Acute renal failure
  • Adolescent
  • Analysis
  • Article
  • Biological markers
  • biomarker
  • Biomarkers
  • Biomarkers - urine
  • cardiopulmonary bypass
  • Cardiopulmonary Bypass - adverse effects
  • Child
  • Child, Preschool
  • Children
  • CKD
  • Cohort Studies
  • Complications and side effects
  • Female
  • female genital diseases
  • Follow-Up Studies
  • Gelatinase
  • Glomerular filtration rate
  • Health risk assessment
  • Heart
  • Heart Defects, Congenital - surgery
  • Heart diseases
  • Heart surgery
  • Humans
  • Hypertension
  • Hypertension - epidemiology
  • Hypertension - etiology
  • Hypertension - urine
  • Infant
  • Interleukin 18
  • Kidney - physiopathology
  • Kidney diseases
  • Kidneys
  • Lipocalin
  • long-term outcomes
  • Male
  • male genital diseases
  • Medicine
  • Medicine & Public Health
  • Monocyte chemoattractant protein
  • Monocyte chemoattractant protein 1
  • Nephrology
  • Original Article
  • Patient outcomes
  • Pediatrics
  • Postoperative Complications - urine
  • pregnancy complications
  • Prospective Studies
  • Renal Insufficiency, Chronic - epidemiology
  • Renal Insufficiency, Chronic - etiology
  • Renal Insufficiency, Chronic - urine
  • Risk factors
  • Surgery
  • Urine
  • urologic
  • Urology
ispartof: Pediatric nephrology (Berlin, West), 2018, Vol.33 (6), p.1069-1077
description: Background We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. Methods Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase–associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. Results Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. Conclusions Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titleKidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery
creatorGreenberg, Jason H ; Devarajan, Prasad ; Thiessen-Philbrook, Heather R ; Krawczeski, Catherine ; Parikh, Chirag R ; Zappitelli, Michael
creatorcontribGreenberg, Jason H ; Devarajan, Prasad ; Thiessen-Philbrook, Heather R ; Krawczeski, Catherine ; Parikh, Chirag R ; Zappitelli, Michael ; TRIBE-AKI Consortium ; for the TRIBE-AKI Consortium
descriptionBackground We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. Methods Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase–associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. Results Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. Conclusions Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.
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languageeng
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subjectacute kidney injury ; Acute Kidney Injury - complications ; Acute Kidney Injury - urine ; Acute renal failure ; Adolescent ; Analysis ; Article ; Biological markers ; biomarker ; Biomarkers ; Biomarkers - urine ; cardiopulmonary bypass ; Cardiopulmonary Bypass - adverse effects ; Child ; Child, Preschool ; Children ; CKD ; Cohort Studies ; Complications and side effects ; Female ; female genital diseases ; Follow-Up Studies ; Gelatinase ; Glomerular filtration rate ; Health risk assessment ; Heart ; Heart Defects, Congenital - surgery ; Heart diseases ; Heart surgery ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension - etiology ; Hypertension - urine ; Infant ; Interleukin 18 ; Kidney - physiopathology ; Kidney diseases ; Kidneys ; Lipocalin ; long-term outcomes ; Male ; male genital diseases ; Medicine ; Medicine & Public Health ; Monocyte chemoattractant protein ; Monocyte chemoattractant protein 1 ; Nephrology ; Original Article ; Patient outcomes ; Pediatrics ; Postoperative Complications - urine ; pregnancy complications ; Prospective Studies ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - etiology ; Renal Insufficiency, Chronic - urine ; Risk factors ; Surgery ; Urine ; urologic ; Urology
ispartofPediatric nephrology (Berlin, West), 2018, Vol.33 (6), p.1069-1077
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1COPYRIGHT 2018 Springer
2Pediatric Nephrology is a copyright of Springer, (2018). All Rights Reserved.
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descriptionBackground We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. Methods Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase–associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. Results Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. Conclusions Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.
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24Health risk assessment
25Heart
26Heart Defects, Congenital - surgery
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32Hypertension - etiology
33Hypertension - urine
34Infant
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36Kidney - physiopathology
37Kidney diseases
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39Lipocalin
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42male genital diseases
43Medicine
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45Monocyte chemoattractant protein
46Monocyte chemoattractant protein 1
47Nephrology
48Original Article
49Patient outcomes
50Pediatrics
51Postoperative Complications - urine
52pregnancy complications
53Prospective Studies
54Renal Insufficiency, Chronic - epidemiology
55Renal Insufficiency, Chronic - etiology
56Renal Insufficiency, Chronic - urine
57Risk factors
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59Urine
60urologic
61Urology
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20female genital diseases
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23Glomerular filtration rate
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26Heart Defects, Congenital - surgery
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30Hypertension
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jtitlePediatric nephrology (Berlin, West)
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date2018-03-06
risdate2018
volume33
issue6
spage1069
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pages1069-1077
issn0931-041X
eissn1432-198X
abstractBackground We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. Methods Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase–associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. Results Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. Conclusions Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.
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pubSpringer Berlin Heidelberg
pmid29511889
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