| Title: |
Urinary biomarkers associated with acute kidney injury in pediatric mechanical circulatory support patients. |
| Authors: |
Harris, Rachel E., Yates, Andrew R., Nandi, Deipanjan, Krawczeski, Catherine D., Klamer, Brett, Martinez, Gabriela Vasquez, Andrade, Gabriel Mayoral, Beckman, Brian F., Bi, Jianli, Zepeda-Orozco, Diana |
| Source: |
Pediatric Nephrology; Feb2024, Vol. 39 Issue 2, p569-577, 9p |
| Subject Terms: |
ARTIFICIAL blood circulation, BIOMARKERS, RESEARCH, ALBUMINS, CONFIDENCE intervals, EPIDERMAL growth factor, PEDIATRICS, RETROSPECTIVE studies, ACQUISITION of data, EXTRACORPOREAL membrane oxygenation, HEART assist devices, COMPARATIVE studies, MEDICAL records, DESCRIPTIVE statistics, RESEARCH funding, ACUTE kidney failure in children, ODDS ratio, LONGITUDINAL method, CREATININE |
| Abstract: |
Background: In patients requiring mechanical circulatory support (MCS), the incidence of acute kidney injury (AKI) is between 37 and 63%. In this study, we performed an exploratory analysis evaluating the relationship of multiple urine biomarkers with AKI development in pediatric MCS patients. Methods: This is a single center retrospective study in a pediatric cohort receiving MCS from August 2014 to November 2020. We measured 14 urine biomarkers of kidney injury on day 1 following MCS initiation and analyzed their association with development of AKI in the first 7 days of MCS initiation. Results: Sixty patients met inclusion criteria. Patients with AKI were more likely to be supported by venoarterial extracorporeal membrane oxygenation (65% vs. 8.3%, p < 0.001), compared to the no AKI group and less likely to have ventricular assist devices (10% vs. 50%, p < 0.001). There was a significant increase in the median urine albumin and urine osteoactivin in the AKI group, compared to the no AKI group (p = 0.020 and p = 0.018, respectively). When normalized to urine creatinine (UCr), an increased log osteoactivin/UCr was associated with higher odds of AKI development (OR: 2.05; 95% CI: 1.07, 4.44; p = 0.028), and higher log epidermal growth factor (EGF)/UCr (OR: 0.41; 95% CI: 0.15, 0.96) was associated with decreased odds of AKI. Conclusions: Early increase in urine osteoactivin is associated with AKI development within 7 days of MCS initiation in pediatric patients. Contrary, an increased urine EGF is associated with kidney protection. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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