Urinary biomarkers associated with acute kidney injury in pediatric mechanical circulatory support patients.
Pediatr Nephrol
; 39(2): 569-577, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-37552466
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. A higher resolution version of the Graphical abstract is available as Supplementary information.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fator de Crescimento Epidérmico
/
Injúria Renal Aguda
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
Pediatr Nephrol
Ano de publicação:
2024
Tipo de documento:
Article