Neutrophil gelatinase-associated lipocalin reflects inflammation and is not a reliable renal biomarker in neonates and infants after cardiopulmonary bypass: a prospective case–control study

Reiter, Karl; Balling, Gunter; Bonelli, Vittorio; Ohain, Jelena Pabst von; Braun, Siegmund; Ewert, Peter; Ruf, Bettina

doi:10.1017/s1047951117001767

Cited by 10 publications

(9 citation statements)

References 33 publications

(87 reference statements)

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“…But in the cases experiencing longer cardiopulmonary bypass (CPB) time (≥75 min), uNGAL increases significantly as early as 2 hours after surgery. 26 KIM-1, a type 1 transmembrance protein, could not be detected in urine normally, but increases promptly after proximal tubular epithelial cells injury, boosting epithelial repair and phagocytosis. In a study with patients younger than 1 year old (including neonates), urinary KIM-1 at 6 hours after CPB has predictive power for AKI, with an AUC of 0.66.…”

Section: Proximal Tubular Cell Biomarkersmentioning

confidence: 89%

Early prediction of acute kidney injury in neonates with cardiac surgery

Shi

Fan

Shu

2020

World Jnl Ped Surgery

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BackgroundAcute kidney injury (AKI) occurs in 42%–64% of the neonatal patients experiencing cardiac surgery, contributing to postoperative morbidity and mortality. Current diagnostic criteria, which are mainly based on serum creatinine and hourly urine output, are not sufficiently sensitive and precise to diagnose neonatal AKI promptly. The purpose of this review is to screen the recent literature, to summarize the novel and cost-effective biomarkers and approaches for neonatal AKI after cardiac surgery (CS-AKI), and to provide a possible research direction for future work.Data sourcesWe searched PubMed for articles published before November 2019 with pertinent terms. Sixty-seven articles were found and screened. After excluding 48 records, 19 articles were enrolled for final analysis.ResultsNineteen articles were enrolled, and 18 possible urinary biomarkers were identified and evaluated for their ability to diagnose CS-AKI. Urinary neutrophil gelatinase-associated lipocalin (uNGAL), serum cystatin C (sCys), urinary human kidney injury molecule-1 (uKIM-1), urinary liver fatty acid-binding protein (uL-FABP) and interleukin-18 (uIL-18) were the most frequently described as the early predictors of neonatal CS-AKI.ConclusionsNeonates are vulnerable to CS-AKI. UNGAL, sCys, uL-FABP, uKIM-1 and uIL-18 are potential biomarkers for early prediction of neonatal CS-AKI. Renal regional oxygen saturation by near-infrared spectroscopy is a non-invasive approach for early identification of neonatal AKI. Further work should focus on exploring a sensitive and specific combined diagnostic model that includes novel biomarkers and other complementary methods.

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Section: Proximal Tubular Cell Biomarkersmentioning

confidence: 89%

Early prediction of acute kidney injury in neonates with cardiac surgery

Shi

Fan

Shu

2020

World Jnl Ped Surgery

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“…Neutrophils are the common type of leukocytes, and arrive rapidly to sites of acute inflammation, where they are responsible for phagocytosis and killing of invading pathogens (12). Neutrophil activation is known to trigger systemic inflammation and has been demonstrated to play a pivotal role in the inflammatory response induced by CPB (6, 13, 14). CPB triggers the activation of neutrophils in the complement cascade, inducing the secretion of polymorphonuclear elastase (PMN-E).…”

Section: Discussionmentioning

confidence: 99%

“…Neutrophil activation can trigger systemic inflammation and has been recognized to play a pivotal role in the inflammatory response induced by CPB (5, 6). Moreover, the neutrophil to lymphocyte ratio (NLR) is a novel inflammatory marker which has been found to be associated with the severity and prognosis of many cardiovascular diseases (7).…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Neutrophil to Lymphocyte Ratio and Clinical Outcome in Pediatric Patients After Cardiopulmonary Bypass Surgery: A Retrospective Study

Sun

Zhang

2019

Front. Pediatr.

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Background: The aim of this study was to investigate the prognostic role of the neutrophil to lymphocyte ratio (NLR) in pediatric patients undergoing open-heart surgery with cardiopulmonary bypass (CPB). Methods: A retrospective cohort study of 61 pediatric patients who underwent CPB in the First Affiliated Hospital of Nanjing Medical University from January 2017 to October 2018 was conducted. All perioperative clinical data, including neutrophil count, lymphocyte count, and C-reactive protein (CRP), were collected retrospectively. The prognostic value of NLR and its association with extubation time, duration of intensive care unit (ICU) stay and in-hospital stay were analyzed. Results: Neutrophil count, NLR, and CRP were significantly increased post-operative compared with pre-operative ( p < 0.05). The increased post-operative levels of NLR were significantly associated with longer extubation time, as well as prolonged post-operative cardiac ICU stay ( p < 0.05). Multivariate linear regression analysis revealed that elevated NLR displayed a significant independent association with extubation time and the duration of an ICU stay. Conclusion: Increased post-operative NLR followed by cardiac surgery with CPB in pediatric patients was associated with longer extubation time and a longer duration of an ICU stay.

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“…It was shown that, with or without sepsis, NGAL could be used as an early marker in neonatal AKI cases. (16) However, in a more recent study, Reiter et al (17) stated that plasma and urine NGAL levels were not reliable markers for developing AKI in neonates after cardiac surgery with cardiopulmonary bypass. In our study, there was no patient diagnosed with AKI.…”

Section: Discussionmentioning

confidence: 99%

The Measurement of Neutrophil Gelatinase Associated Lipocalin In Umbilical Cord Blood And The Assessment Of Its Relationship With Neonatal Results

Ilter

Erugrul

Deger

et al. 2021

Preprint

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Background: The aim of this study was to investigate the relationship between umbilical cord blood neutrophil gelatinase-associated lipocalin and neonatal diseases, such as acute kidney injury. Materials and Method: The neutrophil gelatinase-associated lipocalin levels were measured in umbilical cord blood of 180 babies born in the department of Obstetrics and Gynecology between 2015-2016. Patients were classified according to maternal diseases, neonatal diseases, and demographic features. The obtained data were compared with umbilical cord blood neutrophil gelatinase-associated lipocalin levels. Results: There was a statistically significant difference between umbilical cord blood NGAL levels and premature rupture of membranes (p<0.05), ABO incompatibility (p<0.05), meconium aspiration syndrome (p<0.001), ventricular septal defect (p<0.001), and breech presentation birth (p<0.001). Conclusion: neutrophil gelatinase-associated lipocalin can be useful as a diagnostic biomarker in the evaluation of maternal and neonatal diseases. However, further studies on larger patient populations are needed.

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Neutrophil gelatinase-associated lipocalin reflects inflammation and is not a reliable renal biomarker in neonates and infants after cardiopulmonary bypass: a prospective case–control study

Cited by 10 publications

References 33 publications

Early prediction of acute kidney injury in neonates with cardiac surgery

Early prediction of acute kidney injury in neonates with cardiac surgery

The Relationship Between Neutrophil to Lymphocyte Ratio and Clinical Outcome in Pediatric Patients After Cardiopulmonary Bypass Surgery: A Retrospective Study

The Measurement of Neutrophil Gelatinase Associated Lipocalin In Umbilical Cord Blood And The Assessment Of Its Relationship With Neonatal Results

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