Brandewie Katie, Alten Jeffrey A, Goldstein Stuart L, Rose James, Kim Michael E, Ollberding Nicholas J, Zang Huaiyu, Gist Katja M
Division of Pediatric Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Nephrology and Hypertension, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Pediatr Nephrol. 2025 Apr;40(4):1103-1109. doi: 10.1007/s00467-024-06592-2. Epub 2024 Nov 18.
We evaluate the association of early postoperative urinary c-c motif chemokine ligand 14 (CCL14) and persistent severe acute kidney injury (AKI) in pediatric post-cardiac surgery patients.
This is a retrospective single-center cohort study of patients < 18 years of age undergoing cardiac surgery who provided a biorepository urine sample within the first 24 postoperative hours. Persistent severe AKI was defined as any AKI stage lasting for ≥ 72 h with at least one time point of AKI stage 2 or 3 during that time frame. Patients with persistent severe AKI were matched 2:1 with non-AKI patients on age and sex. Urine samples were measured for CCL14 concentration. Logistic regression was used to evaluate associations between CCL14 and persistent severe AKI.
Persistent severe AKI occurred in 14 (5.4%) patients and was more common in patients with higher surgical complexity and longer cardiopulmonary bypass and cross-clamp duration. Patients with persistent severe AKI had longer median cardiac intensive care unit (CICU) (5 [3, 10] vs. 2 [1.5, 5.5], p-value = 0.039) and hospital length of stays (13.5 [7.8, 16.8] vs. 6 [4,8], p-value = 0.009). There was no difference in CCL14 levels between patients with and without persistent severe AKI (46.7 pg/ml [31.0, 82.9] vs. 44.2 pg/ml [25.1, 74.9], p-value = 0.49) in univariable and logistic regression.
In this heterogenous cohort of children undergoing cardiac surgery, CCL14 was not associated with persistent severe AKI. Future studies are needed to evaluate the use of CCL14 for predicting persistent severe AKI in children.
我们评估了小儿心脏手术后患者术后早期尿中C-C基序趋化因子配体14（CCL14）与持续性严重急性肾损伤（AKI）之间的关联。
这是一项回顾性单中心队列研究，研究对象为年龄小于18岁的心脏手术患者，这些患者在术后24小时内提供了生物样本库尿液样本。持续性严重AKI定义为任何持续≥72小时的AKI分期，且在此时间段内至少有一个时间点为AKI 2期或3期。持续性严重AKI患者与非AKI患者按年龄和性别以2:1进行匹配。检测尿液样本中CCL14浓度。采用逻辑回归评估CCL14与持续性严重AKI之间的关联。
14例（5.4%）患者发生持续性严重AKI，在手术复杂性较高、体外循环和主动脉阻断时间较长的患者中更为常见。持续性严重AKI患者的心脏重症监护病房（CICU）中位住院时间更长（5[3,10]天 vs. 2[1.5,5.5]天，p值 = 0.039），住院时间也更长（13.5[7.8,16.8]天 vs. 6[4,8]天，p值 = 0.009）。在单变量分析和逻辑回归中，持续性严重AKI患者与非持续性严重AKI患者的CCL14水平无差异（46.7 pg/ml[31.0,82.9] vs. 44.2 pg/ml[25.1,74.9]，p值 = 0.49）。
在这个接受心脏手术的异质性儿童队列中，CCL14与持续性严重AKI无关。未来需要进行研究以评估CCL14在预测儿童持续性严重AKI中的应用。
