Assessment and Prognosis in CSA-AKI Using Novel Kidney Injury Biomarkers: A Prospective Observational Study

Udzik, Jakub; Waszczyk, Aleksandra; Safranow, Krzysztof; Biskupski, Andrzej; Majer, Krzysztof; Kwiatkowski, Sebastian; Kwiatkowska, Ewa

doi:10.3390/biology10090823

Cited by 4 publications

(2 citation statements)

References 55 publications

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“…Indeed, the KDIGO score for the assessment of kidney failure confirmed that most human patients do not present kidney failure in this study, which is consistent with the literature [ 30 , 31 ]. Acute kidney failure or AKI during and after CPB is currently a major research challenge [ 30 , 32 , 33 ] for both biomarker and therapeutic research. AKIs are the consequence of common adverse events, including hemodilution, hemolysis, inflammation [ 34 ], neuro–hormonal changes, and vasopressor use and misuse during CPB in cardiac surgeries.…”

Section: Discussionmentioning

confidence: 99%

A Rat Model of Clinically Relevant Extracorporeal Circulation Develops Early Organ Dysfunctions

Persello

Souab

Dupas

et al. 2023

IJMS

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In clinical practice, extracorporeal circulation (ECC) is associated with coagulopathy and inflammation, eventually leading to organ injuries without preventive systemic pharmacological treatment. Relevant models are needed to reproduce the pathophysiology observed in humans and preclinical tests. Rodent models are less expensive than large models but require adaptations and validated comparisons to clinics. This study aimed to develop a rat ECC model and to establish its clinical relevance. One hour of veno-arterial ECC or a sham procedure were achieved on mechanically ventilated rats after cannulations with a mean arterial pressure objective > 60 mmHg. Five hours post-surgery, the rats’ behavior, plasmatic/blood biomarkers, and hemodynamics were measured. Blood biomarkers and transcriptomic changes were compared in 41 patients undergoing on-pump cardiac surgery. Five hours post-ECC, the rats presented hypotension, hyperlactatemia, and behavioral alterations. The same patterns of marker measurements (Lactate dehydrogenase, Creatinine kinase, ASAT, ALAT, and Troponin T) were observed in both rats and human patients. Transcriptome analyses showed similarity in both humans and rats in the biological processes involved in the ECC response. This new ECC rat model seems to resemble both ECC clinical procedures and the associated pathophysiology, but with early organ injury corresponding to a severe phenotype. Although the mechanisms at stake in the post-ECC pathophysiology of rats or humans need to be described, this new rat model appears to be a relevant and costless preclinical model of human ECC.

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Section: Discussionmentioning

confidence: 99%

A Rat Model of Clinically Relevant Extracorporeal Circulation Develops Early Organ Dysfunctions

Persello

Souab

Dupas

et al. 2023

IJMS

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“…The data used in this study correspond to the Heart Institute, Hospital “das Clínicas”, Faculty of Medicine, University of São Paulo, Brazil, to compare the length of stay of

patients with heart disease undergoing cardiac surgery [ 45 ]. The considered covariates are: age of the patient, type of protocol, race, sex, and type of patient.…”

Section: Application To Biomedical Datamentioning

confidence: 99%

Weibull Regression and Machine Learning Survival Models: Methodology, Comparison, and Application to Biomedical Data Related to Cardiac Surgery

Cavalcante

Ospina

Leiva

et al. 2023

Biology

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In this article, we propose a comparative study between two models that can be used by researchers for the analysis of survival data: (i) the Weibull regression model and (ii) the random survival forest (RSF) model. The models are compared considering the error rate, the performance of the model through the Harrell C-index, and the identification of the relevant variables for survival prediction. A statistical analysis of a data set from the Heart Institute of the University of São Paulo, Brazil, has been carried out. In the study, the length of stay of patients undergoing cardiac surgery, within the operating room, was used as the response variable. The obtained results show that the RSF model has less error rate for the training and testing data sets, at 23.55% and 20.31%, respectively, than the Weibull model, which has an error rate of 23.82%. Regarding the Harrell C-index, we obtain the values 0.76, 0.79, and 0.76, for the RSF and Weibull models, respectively. After the selection procedure, the Weibull model contains variables associated with the type of protocol and type of patient being statistically significant at 5%. The RSF model chooses age, type of patient, and type of protocol as relevant variables for prediction. We employ the randomForestSRC package of the R software to perform our data analysis and computational experiments. The proposal that we present has many applications in biology and medicine, which are discussed in the conclusions of this work.

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The Utility of Novel Kidney Injury Biomarkers in Early Detection of CSA-AKI

Udzik

Waszczyk

Wojciechowska‐Koszko

et al. 2022

IJMS

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Cardiac surgery-associated acute kidney injury (CSA-AKI) is one of the most common complications of cardiac surgery procedures. In this study, the authors attempt to provide new data regarding the application of novel kidney injury biomarkers in the early diagnostics of CSA-AKI. 128 adult patients undergoing elective cardiac surgery procedures with the use of cardiopulmonary by-pass (CPB) were enrolled in this study. Novel kidney injury biomarkers were marked in the plasma and urine 6 h after weaning from the CPB. A significant difference in the postoperative biomarkers’ concentration between the AKI and no-AKI group was found, regarding plasma IL-8, plasma TNF-α and urine NGAL, normalized for creatinine excretion (NGAL/Cr). These were also independent predictors of CSA-AKI. An independent risk factor for CSA-AKI proved to be preoperative CKD. Plasma IL-8 and TNF-α, as well as urine NGAL/Cr, are independent early indicators of CSA-AKI and pose a promising alternative for creatinine measurements. The cut-off points for these biomarkers proposed in this investigation should be confronted with more data and revised to achieve a suitable diagnostic value.

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Assessment and Prognosis in CSA-AKI Using Novel Kidney Injury Biomarkers: A Prospective Observational Study

Cited by 4 publications

References 55 publications

A Rat Model of Clinically Relevant Extracorporeal Circulation Develops Early Organ Dysfunctions

A Rat Model of Clinically Relevant Extracorporeal Circulation Develops Early Organ Dysfunctions

Weibull Regression and Machine Learning Survival Models: Methodology, Comparison, and Application to Biomedical Data Related to Cardiac Surgery

The Utility of Novel Kidney Injury Biomarkers in Early Detection of CSA-AKI

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