Serum Lactate As Reliable Biomarker of Acute Kidney Injury in Low-risk Cardiac Surgery Patients.
Kidney Injury Molecule-1
Neutrophil Gelatinase-Associated Lipocalin
acute kidney injury
cardiac surgery
lactate
Journal
Journal of medical biochemistry
ISSN: 1452-8258
Titre abrégé: J Med Biochem
Pays: Serbia
ID NLM: 101315490
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
04
04
2018
accepted:
25
04
2018
entrez:
15
3
2019
pubmed:
15
3
2019
medline:
15
3
2019
Statut:
epublish
Résumé
Cardiac surgery-associated acute kidney injury (CSA-AKI) frequently occurs in patients assessed as low-risk for developing CSA-AKI. Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule-1 (KIM-1) and lactate are promising biomarkers of CSA-AKI but have not yet been explored in low-risk patients. To evaluate urinary NGAL (uNGAL), KIM-1 and lactate as biomarkers of CSA-AKI in patients with low-risk for developing CSA-AKI. This prospective, observational study included 100 adult elective cardiac surgery patients assessed as low-risk for developing CSA-AKI. UNGAL, KIM-1 and lactate were measured preoperatively, at the end of cardiopulmonary bypass (CPB) and 3, 12, 24 and 48 h later. Fifteen patients developed CSA-AKI. Patients with CSA-AKI had significantly higher lactate but similar uNGAL and KIM-1 levels compared to patients without CSA-AKI. Unlike uNGAL and KIM-1, postoperative lactate was good biomarker of CSA-AKI with the highest odds ratio (OR) 2.7 [1.4-4.9] 24 h after CPB. Peak lactate concentration ≥ 4 mmol/L carried dramatically higher risk for developing CSA-AKI (OR 6.3 [1.9-20.5]). Unlike uNGAL and KIM-1, postoperative lactate was significant independent predictor of CSA-AKI with the highest odds ratio 24 h after CPB. Akutno oštećenje bubrega nakon kardiohirurških procedura (KH-AOB) nastaje često i kod bolesnika koji su ocenjeni kao niskorizični za nastanak KH-AOB. Neutrofilna želatinaza udružena sa lipokalinom (NGAL), bubrežni štetni molekul-1 (KIM-1) i laktat su novi biomarkeri KH-AOB ali do sada nisu ispitivani kod niskorizičnih bolesnika. Ispitati urinarni NGAL (uNGAL), KIM-1 i laktat kao biomarkere KH-AOB kod bolesnika koji su ocenjeni kao niskorizični za nastanak KH-AOB. Ovom prospektivnom opservacionom studijom obuhvaćeno je 100 odraslih elektivnih kardiohirurških bolesnika koji su ocenjeni kao niskorizični za razvoj KH-AOB. UNGAL, KIM-1 i laktat su određivani preoperativno, na kraju kardiopulmonalnog bajpasa (KPB) kao i 3, 12, 24 i 48 sati kasnije. KH-AOB se razvilo kod 15 bolesnika. Bolesnici sa KH-AOB su imali značajno više vrednosti lakatata ali slične vrednosti uNGAL i KIM-1 u poređenju sa bolesnicima bez KH-AOB. Za razliku od uNGAL i KIM-1, vrednost lakatata posle operacije se pokazala kao pouzdan biomarker KH-AOB sa najvišim OR 2.7 [1,4–4,9] 24 sata nakon završetka KPB. Vrednosti lakatata ≥ 4 mmol/L su bile povezane sa dramatično povišenim rizikom za nastanak KH-AOB (OR 6,3 [1,9–20,5]). Za razliku od uNGAL i KIM-1, vrednosti lakata posle operacije su bile značajan nezavisni prediktor razvoja KH-AOB sa najboljom prediktivnom vrednošću 24 sata nakon završetka KPB.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiac surgery-associated acute kidney injury (CSA-AKI) frequently occurs in patients assessed as low-risk for developing CSA-AKI. Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule-1 (KIM-1) and lactate are promising biomarkers of CSA-AKI but have not yet been explored in low-risk patients.
AIM
OBJECTIVE
To evaluate urinary NGAL (uNGAL), KIM-1 and lactate as biomarkers of CSA-AKI in patients with low-risk for developing CSA-AKI.
METHODS
METHODS
This prospective, observational study included 100 adult elective cardiac surgery patients assessed as low-risk for developing CSA-AKI. UNGAL, KIM-1 and lactate were measured preoperatively, at the end of cardiopulmonary bypass (CPB) and 3, 12, 24 and 48 h later.
RESULTS
RESULTS
Fifteen patients developed CSA-AKI. Patients with CSA-AKI had significantly higher lactate but similar uNGAL and KIM-1 levels compared to patients without CSA-AKI. Unlike uNGAL and KIM-1, postoperative lactate was good biomarker of CSA-AKI with the highest odds ratio (OR) 2.7 [1.4-4.9] 24 h after CPB. Peak lactate concentration ≥ 4 mmol/L carried dramatically higher risk for developing CSA-AKI (OR 6.3 [1.9-20.5]).
CONCLUSIONS
CONCLUSIONS
Unlike uNGAL and KIM-1, postoperative lactate was significant independent predictor of CSA-AKI with the highest odds ratio 24 h after CPB.
UVOD
UNASSIGNED
Akutno oštećenje bubrega nakon kardiohirurških procedura (KH-AOB) nastaje često i kod bolesnika koji su ocenjeni kao niskorizični za nastanak KH-AOB. Neutrofilna želatinaza udružena sa lipokalinom (NGAL), bubrežni štetni molekul-1 (KIM-1) i laktat su novi biomarkeri KH-AOB ali do sada nisu ispitivani kod niskorizičnih bolesnika.
CILJ
UNASSIGNED
Ispitati urinarni NGAL (uNGAL), KIM-1 i laktat kao biomarkere KH-AOB kod bolesnika koji su ocenjeni kao niskorizični za nastanak KH-AOB.
METODE
METHODS
Ovom prospektivnom opservacionom studijom obuhvaćeno je 100 odraslih elektivnih kardiohirurških bolesnika koji su ocenjeni kao niskorizični za razvoj KH-AOB. UNGAL, KIM-1 i laktat su određivani preoperativno, na kraju kardiopulmonalnog bajpasa (KPB) kao i 3, 12, 24 i 48 sati kasnije.
REZULTATI
UNASSIGNED
KH-AOB se razvilo kod 15 bolesnika. Bolesnici sa KH-AOB su imali značajno više vrednosti lakatata ali slične vrednosti uNGAL i KIM-1 u poređenju sa bolesnicima bez KH-AOB. Za razliku od uNGAL i KIM-1, vrednost lakatata posle operacije se pokazala kao pouzdan biomarker KH-AOB sa najvišim OR 2.7 [1,4–4,9] 24 sata nakon završetka KPB. Vrednosti lakatata ≥ 4 mmol/L su bile povezane sa dramatično povišenim rizikom za nastanak KH-AOB (OR 6,3 [1,9–20,5]).
ZAKLJUČAK
UNASSIGNED
Za razliku od uNGAL i KIM-1, vrednosti lakata posle operacije su bile značajan nezavisni prediktor razvoja KH-AOB sa najboljom prediktivnom vrednošću 24 sata nakon završetka KPB.
Autres résumés
Type: Publisher
(srp)
Akutno oštećenje bubrega nakon kardiohirurških procedura (KH-AOB) nastaje često i kod bolesnika koji su ocenjeni kao niskorizični za nastanak KH-AOB. Neutrofilna želatinaza udružena sa lipokalinom (NGAL), bubrežni štetni molekul-1 (KIM-1) i laktat su novi biomarkeri KH-AOB ali do sada nisu ispitivani kod niskorizičnih bolesnika.
Identifiants
pubmed: 30867639
doi: 10.2478/jomb-2018-0018
pii: jomb-2018-0018
pmc: PMC6411001
doi:
Types de publication
Journal Article
Langues
eng
Pagination
118-125Déclaration de conflit d'intérêts
Conflict of interest Conflict of interest statement: The authors stated that they have no conflicts of interest regarding the publication of this article.
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