Kalisnik Jurij Matija, Steblovnik Klemen, Hrovat Eva, Jerin Ales, Skitek Milan, Dinges Christian, Fischlein Theodor, Zibert Janez
Department of Cardiac Surgery, Paracelsus Medical University, 40791 Nuremberg, Germany.
Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia.
J Cardiovasc Dev Dis. 2022 Jul 1;9(7):210. doi: 10.3390/jcdd9070210.
We have recently shown that minor subclinical creatinine dynamic changes enable the excellent detection of acute kidney injury (AKI) within 6-12 h after cardiac surgery. The aim of the present study was to examine a combination of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC) and creatinine for enhanced AKI detection early after cardiac surgery. Elective patients with normal renal function undergoing cardiac surgery using cardiopulmonary bypass were enrolled. Concentrations of plasma NGAL, serum CysC and serum creatinine were determined after the induction of general anesthesia, at the termination of the cardiopulmonary bypass and 2 h thereafter. Out of 119 enrolled patients, 51 (43%) developed AKI. A model utilizing an NGAL, CysC and creatinine triple biomarker panel including sequential relative changes provides a better prediction of cardiac surgery-associated acute kidney injury than any biomarker alone already 2 h after the termination of the cardiopulmonary bypass. The area under the receiver-operator curve was 0.77, sensitivity 77% and specificity 68%.
我们最近发现，轻微的亚临床肌酐动态变化能够在心脏手术后6 - 12小时内出色地检测出急性肾损伤（AKI）。本研究的目的是检测中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、胱抑素C（CysC）和肌酐的组合，以在心脏手术后早期增强对AKI的检测。纳入接受体外循环心脏手术且肾功能正常的择期患者。在全身麻醉诱导后、体外循环结束时及此后2小时测定血浆NGAL、血清CysC和血清肌酐的浓度。在119名纳入研究的患者中，51名（43%）发生了AKI。一个利用包括连续相对变化的NGAL、CysC和肌酐三联生物标志物组合的模型，比任何单一生物标志物都能更好地预测体外循环结束后2小时的心脏手术相关急性肾损伤。受试者工作特征曲线下面积为0.77，敏感性为77%，特异性为68%。
