Unknown

Dataset Information

0

Perioperative albuminuria and clinical model to predict acute kidney injury in paediatric cardiac surgery.


ABSTRACT:

Background

AKI is an important complication post cardiac surgery in children. An early diagnosis can help in mitigating complications and allow for prognostication. Urinary albumin:creatinine ratio (ACR) as a biomarker can provide a cheaper and more accessible AKI risk assessment and prediction. There is a paucity of paediatric literature regarding its utility.

Methods

This was a prospective observational study, enrolling all children aged 1 month to 18 years, who underwent cardiac surgery, with use of cardiopulmonary bypass. Cohort was divided into groups < 2 years and ≥ 2 years for analyses to account for differences in physiological albumin excretion with age.

Results

Of 143 children enrolled in the study, 36 developed AKI. In both age groups, the post-operative ACR was higher than pre-operative ACR among patients with and without AKI. In the group aged ≥ 2 years, the highest first post-operative ACR tertile (> 75.8 mg/g) predicted post-operative AKI after adjusting for clinical variables (adjusted RR, 11.71; 1.85-16.59). In the group aged < 2 years, the highest first post-operative ACR tertile (> 141.3 mg/g) predicted post-operative AKI in unadjusted analysis but not after adjusting for clinical variables (RR, 2.78; 0.70-6.65). For AKI risk prediction, AUC (95% CI) was highest after combining clinical model and pre-operative ACR for groups aged < 2 years [0.805 (0.713-0.896)] and ≥ 2 years [0.872 (0.772-0.973)].

Conclusions

This study provides evidence for use of albuminuria as a feasible biomarker in AKI prediction in children post cardiac surgery, especially when added to a clinical model. A higher resolution version of the Graphical abstract is available as Supplementary information.

SUBMITTER: Nautiyal A 

PROVIDER: S-EPMC8451727 | biostudies-literature |

REPOSITORIES: biostudies-literature

Similar Datasets

| S-EPMC3338298 | biostudies-literature
| S-EPMC4998548 | biostudies-literature
| S-EPMC8466978 | biostudies-literature
| S-EPMC4843765 | biostudies-literature
| S-EPMC3171945 | biostudies-literature
| S-EPMC6895663 | biostudies-literature
| S-EPMC3171944 | biostudies-literature
| S-EPMC4566816 | biostudies-other
| S-EPMC8905398 | biostudies-literature
2014-09-29 | E-GEOD-44782 | biostudies-arrayexpress