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01-06-2018 | Original Article

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

Authors: Jason H. Greenberg, Prasad Devarajan, Heather R. Thiessen-Philbrook, Catherine Krawczeski, Chirag R. Parikh, Michael Zappitelli, for the TRIBE-AKI Consortium

Published in: Pediatric Nephrology | Issue 6/2018

Abstract

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.

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Title: Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery
Authors: Jason H. Greenberg
Prasad Devarajan
Heather R. Thiessen-Philbrook
Catherine Krawczeski
Chirag R. Parikh
Michael Zappitelli
for the TRIBE-AKI Consortium
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 6/2018
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-3888-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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