Mass Spectrometry–Based Proteomic Analysis of Urine in Acute Kidney Injury Following Cardiopulmonary Bypass: A Nested Case-Control Study

Ho, Julie; Lucy, Malcolm; Krokhin, Oleg V.; HayGlass, Kent T.; Pascoe, Edward; Darroch, Gayle; Rush, David; Nickerson, Peter; Rigatto, Claudio; Reslerova, Martina

doi:10.1053/j.ajkd.2008.10.037

Cited by 140 publications

(149 citation statements)

References 40 publications

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“…Recent proteomic studies indicate that all patients undergoing cardiac surgery with CPB develop the early stages of ischemia-reperfusion kidney injury, but whether they go on to develop AKI depends on both the occurrence of other renal insults as well as the severity of the ensuing inflammatory response, renal hypoxia, and oxidative stress. 21 Anemia and RBC transfusion could cause AKI either by harming the kidney directly or by increasing patients' susceptibility to concomitant renal insults.…”

Section: Discussionmentioning

confidence: 99%

Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study

Karkouti

Grocott

Hall

et al. 2014

Can J Anesth/J Can Anesth

141

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Section: Discussionmentioning

confidence: 99%

Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study

Karkouti

Grocott

Hall

et al. 2014

Can J Anesth/J Can Anesth

141

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“…In a prospective, nested case-control study of CPB patients, our group identified elevated urinary hepcidin-25 in patients who do not develop AKI after cardiac surgery (11). These urines were analyzed with surface-enhanced laser desorption ionization time-offlight mass spectrometry (SELDI TOF-MS).…”

Section: Introductionmentioning

confidence: 99%

Urinary Hepcidin-25 and Risk of Acute Kidney Injury Following Cardiopulmonary Bypass

Reslerova²,

Gali³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Acute kidney injury (AKI) complicating cardiopulmonary bypass (CPB) results in increased morbidity and mortality. Urinary hepcidin-25 has been shown to be elevated in patients who do not develop AKI after CPB using semiquantitative mass spectrometry (SELDI TOF-MS). The goals of this study were to quantitatively validate these findings with ELISA and evaluate the diagnostic performance of hepcidin-25 for AKI.Design, setting, participants, & measurements A nested, case-control analysis of urinary hepcidin-25 in AKI (n ϭ 22) and non-AKI (n ϭ 22) patients was conducted to validate the SELDI TOF-MS data at the following times: preoperatively; the start of CPB; 1 hour on CPB; on arrival to the intensive care unit; and postoperative days (POD) 1 and 3 to 5. The diagnostic performance of hepcidin-25 was then evaluated in the entire prospective observational cohort (n ϭ 338) at POD 1. AKI was defined as Cr Ͼ50% from baseline, within 72 hours postoperatively.Results Urinary hepcidin-25/Cr ratio was significantly elevated in all patients at POD 1 compared with baseline (P Ͻ 0.0005) and was also significantly elevated in non-AKI versus AKI patients at POD 1 (P Ͻ 0.0005). Increased log 10 hepcidin-25/Cr ratio was strongly associated with avoidance of AKI on univariate analysis. On multivariate analysis, the log 10 hepcidin-25/Cr ratio (P Ͻ 0.0001) was associated with avoidance of AKI with an area under the curve of 0.80, sensitivity 0.68, specificity 0.68, and negative predictive value 0.96. ConclusionsElevated urinary hepcidin-25 on POD 1 is a strong predictor of avoidance of AKI beyond postoperative day 1.

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“…Clinical studies indicate urine and serum neutrophil gelatinase-associated lipocalin as highly sensitive, specific, and predictive of AKI in many different disease processes (14). Recently, urinary hepcidin has been suggested as a candidate biomarker of AKI (24). Despite the enthusiasm with novel biomarkers, most of them are still not available for routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Open Heart Surgery Associated Acute Kidney Injury in Children

Krastiņš

Straume

Auziņš

et al. 2013

Acta Chirurgica Latviensis

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Summary.Introduction. Cardiac surgery with cardiopulmonary bypass (CPB) is commonly perceived as a risk factor for decline in renal function. Hypothermia, hypoxia, hypotension, non-pulsatile blood flow during CPB, use of ACE inhibitors, inotropic and (or) vasoactive support affects kidney and contributes to the acute kidney injury (AKI). Aim of the study. The purpose of this study was to evaluate the incidence, severity and outcome of CPB related AKI in children after open heart surgery. Materials and methods. We conducted prospective, non-randomized observational study at the tertiary care University Children's Hospital Pediatric ICU. We enrolled 30 patients, 12 boys and 18 girls with congenital heart disease (CHD). Their median body weight was 6,8 kg, (IQR 5,2<8,2 kg) and median age 7 months (IQR 5<10 months). SCr was determined and preoperative and postoperative creatinine clearance (ClCr) was estimated using Schwarz formula (eClCr). During surgical repair and till the end of the first 12 postoperative hours urine was collected to measure ClCr, using the difference in urine (UCr) and SCr concentrations (mClCr). Urine output, body temperature, duration of aortic cross clamping and cardiopulmonary bypass was recorded. Results. Median intraoperative urine output was 2,4 ml/kg/h (IQR 1,29<3,15 ml/kg/h). Median CPB time was 147 min., (IQR 116,75<205 min.), median aortic cross-clamping time was 95 min., (IQR 70,5<133 min.), cooling during CPB to 29,75°C. Postoperative SCr increased to 35 μmol/l (IQR 27,5<50,5 μmol/l) vs. preoperative SCr 29 μmol/l (IQR 24<32,9 μmol/l), P<0,0001. GFR declined from preoperative 98,4 ml/min./1,73 m2 (IQR 89,6<123,04) to postoperative 80,98 ml/min./1,73 m2, (IQR 60,73<97,97 ml/min./1,73 m2), P<0,0001. We find statistically significant difference (P=0,042) in measured 39,88 ml/min./1,73 m2 (IQR 21,96<67,82 ml/min./1,73 m2) versus estimated ClCr (eClCr) 80,98 ml/min./1,73 m2, (IQR 60,73<97,97 ml/min./1,73 m2). Observed prevalence of AKI was 46,6% (14/30 patients met KDIGO criteria for AKI). Conclusions. Open heart surgery in children has severe, but transient effect on expression of renal biomarkers. There was a marked difference between measured and estimated ClCr in our patients. Observed incidence of AKI was 46,6% (14 patients met KDIGO criteria of AKI from 30 of our patients). Before discharge from the hospital both biomarkers returned to normal values.

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Mass Spectrometry–Based Proteomic Analysis of Urine in Acute Kidney Injury Following Cardiopulmonary Bypass: A Nested Case-Control Study

Cited by 140 publications

References 40 publications

Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study

Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study

Urinary Hepcidin-25 and Risk of Acute Kidney Injury Following Cardiopulmonary Bypass

Open Heart Surgery Associated Acute Kidney Injury in Children

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