Rapid Detection of Acute Kidney Injury by Plasma and Urinary Neutrophil Gelatinase-associated Lipocalin After Cardiopulmonary Bypass

• DOI: 10.1097/fjc.0b013e31819d6139
• Publication Date: 2009-05-21T12:54:56Z
• Authors: Sampurna M Tuladhar; Valentina O Püntmann; Manish Soni; Prakash P Punjabi; Richard G Bogle
• Keywords: Neutrophil gelatinase-associated lipocalin

Background: Cardiopulmonary bypass (CPB) is associated with a significant risk of postoperative renal dysfunction. We studied the utility novel biomarker in predicting acute kidney injury (AKI) adult patients undergoing cardiac surgery. Methods and Results: Blood urine were obtained from 50 CPB-requiring Patients divided into group A (n = 41) normal creatinine pre-bypass post-bypass B 9) who developed an increase serum >0.5 mg/dL within first 48 hours post CPB. Plasma urinary neutrophil gelatinase-associated lipocalin (NGAL) was determined at baseline 2 after levels NGAL higher AKI [214 ± 16.7 ng/mL (95% CI 176.9-252.9)] compared those did not [149.5 13.5 122.1-175.7); P 0.035]. Two CPB, there (P 0.0003) levels, greater [476.1 41.1 380.6-571.6); 0.0003] [278.4 22 233.9-323.0)]. In group, increased 7.13 2.30 2.5-11.8) to 2924 786 1110-4739). non-AKI 1.6 0.6 0.3-3.0) 749 179 386-1113). The post-CPB significantly different < 0.0001) such that suitable threshold for use as diagnostic test could be determined. Receiver operating characteristics plasma area under curve (AUC) 0.80 0.96, respectively. For 433 ng/mmol creatinine, had 90% sensitivity 78% specificity detection Conclusions: Measurement this or CPB predictive subsequent injury. Although AUC seemed inferior urine, even 0.8 reported compares very favorably other "outstanding" biomarkers (eg, AUCs 0.7 range troponin).