Potential of Urine Biomarkers CHI3L1, NGAL, TIMP-2, IGFBP7, and Combinations as Complementary Diagnostic Tools for Acute Kidney Injury after Pediatric Cardiac Surgery: A Prospective Cohort Study
Wim Vandenberghe,
Jorien De Loor,
Katrien Francois,
Kristof Vandekerckhove,
Ingrid Herck,
Johan Vande Walle,
Harlinde Peperstraete,
Thierry Bové,
Daniël De Wolf,
Lieve Nuytinck,
Jan J. De Waele,
Evelyne Meyer,
Eric A. J. Hoste
Affiliations
Wim Vandenberghe
Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Jorien De Loor
Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Katrien Francois
Department of Cardiac Surgery, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Kristof Vandekerckhove
Department of Pediatric Cardiology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Ingrid Herck
Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Johan Vande Walle
Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Harlinde Peperstraete
Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Thierry Bové
Department of Cardiac Surgery, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Daniël De Wolf
Department of Pediatric Cardiology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Lieve Nuytinck
Health, Innovation and Research Institute UZ Gent, Ghent University Hospital, 9000 Ghent, Belgium
Jan J. De Waele
Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Evelyne Meyer
Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, 9000 Ghent, Belgium
Eric A. J. Hoste
Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
Acute kidney injury (AKI) is common after pediatric cardiac surgery (CS). Several urine biomarkers have been validated to detect AKI earlier. The objective of this study was to evaluate urine CHI3L1, NGAL, TIMP-2, IGFBP7, and NephroCheck® as predictors for AKI ≥ 1 in pediatric CS after 48 h and AKI ≥ 2 after 12 h. Pediatric patients (age ® were measured during surgery and intensive care unit (ICU) stay and corrected for urine dilution. One hundred and one pediatric patients were included. AKI ≥ 1 within 48 h after ICU admission occurred in 62.4% and AKI ≥ 2 within 12 h in 30.7%. All damage biomarkers predicted AKI ≥ 1 within 48 h after ICU admission, when corrected for urine dilution: CHI3L1 (AUC-ROC: 0.642 (95% CI, 0.535–0.741)), NGAL (0.765 (0.664–0.848)), TIMP-2 (0.778 (0.662–0.868)), IGFBP7 (0.796 (0.682–0.883)), NephroCheck® (0.734 (0.614–0.832)). Similarly, AKI ≥ 2 within 12 h was predicted by all damage biomarkers when corrected for urine dilution: uCHI3L1 (AUC-ROC: 0.686 (95% CI, 0.580–0.780)), NGAL (0.714 (0.609–0.804)), TIMP-2 (0.830 (0.722–0.909)), IGFBP7 (0.834 (0.725–0.912)), NephroCheck® (0.774 (0.658–0.865)). After pediatric cardiac surgery, the damage biomarkers urine CHI3L1, NGAL, TIMP-2, IGFBP7, and NephroCheck® reliably predict AKI after correction for urine dilution.
