Cardiac surgery–associated neutrophil gelatinase–associated lipocalin score for postoperative acute kidney injury: What is the clinical implication?

Kališnik, Jurij Matija; Fischlein, Theodor; Santarpino, Giuseppe

doi:10.1016/j.jtcvs.2017.03.088

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…Moreover, by determining NGAL and CysC in conjunction with creatinine, the identification of patients prone to CSA-AKI was made possible within the first two hours after surgery. These preliminary results are in harmony with our assertions that anticipated the further improvement of CSA-AKI by combining NGAL, CysC and creatinine serum concentrations as well as their changes over time [17].…”

Section: Discussionsupporting

confidence: 88%

“…However, new data shows that even small increments of creatinine early after surgery can predict the development of AKI [ 9 , 10 , 28 , 32 ]. We speculated that, combined with NGAL and CysC, a triple biomarker model including creatinine could provide a simple fine-tuning tool for the prediction of CSA-AKI in the very early preclinical stage [ 17 ]. Indeed, the present study confirms our previous observations that even small incremental creatinine changes in the absence of a clinically relevant absolute creatinine increase provide a solid, often overseen basis for early CSA-AKI diagnosis [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Enhanced Detection of Cardiac Surgery-Associated Acute Kidney Injury by a Composite Biomarker Panel in Patients with Normal Preoperative Kidney Function

Kališnik

Steblovnik

Hrovat

et al. 2022

JCDD

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We have recently shown that minor subclinical creatinine dynamic changes enable the excellent detection of acute kidney injury (AKI) within 6–12 h after cardiac surgery. The aim of the present study was to examine a combination of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC) and creatinine for enhanced AKI detection early after cardiac surgery. Elective patients with normal renal function undergoing cardiac surgery using cardiopulmonary bypass were enrolled. Concentrations of plasma NGAL, serum CysC and serum creatinine were determined after the induction of general anesthesia, at the termination of the cardiopulmonary bypass and 2 h thereafter. Out of 119 enrolled patients, 51 (43%) developed AKI. A model utilizing an NGAL, CysC and creatinine triple biomarker panel including sequential relative changes provides a better prediction of cardiac surgery-associated acute kidney injury than any biomarker alone already 2 h after the termination of the cardiopulmonary bypass. The area under the receiver-operator curve was 0.77, sensitivity 77% and specificity 68%.

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Section: Discussionsupporting

confidence: 88%