Usefulness of Urinary Biomarkers in Early Detection of Acute Kidney Injury After Cardiac Surgery in Adults

Background: Acute kidney injury (AKI) is a common complication after cardiac surgery. Urinary liver-type fatty acid-binding protein (L-FABP) reflects the presence of renal tubular injury. The aim of the present study was to evaluate the utility of urinary L-FABP compared with other urinary biomarker...

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Bibliographic Details
Published in:Circulation Journal 2012, Vol.76(1), pp.213-220
Main Authors: Matsui, Katsuomi, Kamijo-Ikemori, Atsuko, Sugaya, Takeshi, Yasuda, Takashi, Kimura, Kenjiro
Format: Article
Language:English
Subjects:
Acute kidney injury
Acute Kidney Injury - diagnosis
Acute Kidney Injury - urine
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers - urine
Cardiac surgery
Fatty Acid-Binding Proteins - urine
Female
Humans
Liver-type fatty acid-binding protein
Logistic Models
Male
Middle Aged
Postoperative Complications
Predictive Value of Tests
Prospective Studies
Thoracic Surgery
Time Factors
Young Adult
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Summary:Background: Acute kidney injury (AKI) is a common complication after cardiac surgery. Urinary liver-type fatty acid-binding protein (L-FABP) reflects the presence of renal tubular injury. The aim of the present study was to evaluate the utility of urinary L-FABP compared with other urinary biomarkers for the early detection of postoperative AKI among adult patients undergoing cardiac surgery. Methods and Results: Patients were divided into the AKI (n=48) and non-AKI groups (n=37) according to whether they developed postoperative AKI within 48h after surgery. Changes in various biomarkers were evaluated. Urine and serum samples were obtained from each patient at the following time points: before the operation, immediately after the operation, and 3, 6, 18, 24, and 48h postoperatively. The urinary L-FABP level was significantly higher in the AKI group than in the non-AKI group at every time point, while other biomarkers did not show such a tendency. The biomarker with the largest area under the curve at every time point for predicting the onset of AKI was urinary L-FABP. On multiple logistic regression analysis, the urinary L-FABP level before operation and within the first 6h after cardiac surgery was significantly associated with the onset of AKI. Conclusions: Urinary L-FABP is a useful biomarker for early detection of AKI and is a good early predictor of the onset of AKI. (Circ J 2012; 76: 213-220)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-11-0342