Proteomic Identification of Early Biomarkers of Acute Kidney Injury After Cardiac Surgery in Children

摘要: Background Serum creatinine is a delayed marker of acute kidney injury (AKI). Our purpose to discover and validate novel early urinary biomarkers AKI after cardiac surgery. Study Design Diagnostic test study. Setting & Participants Children undergoing cardiopulmonary bypass The set included 15 participants with matched controls (median age, 1.5 year) 45 without AKI. validation 365 children 1.9 year). Index Tests Biomarkers identified using proteomic profiling: α 1 -microglobulin, -acid glycoprotein, albumin. Reference Test AKI, defined as ≥50% increase in serum level from baseline within 3 days Results Proteomic profiling surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) showed protein peaks that appeared consistently 2 hours who developed proteins were Using clinical assays, results confirmed validated an independent prospective cohort. In the set, 135 (37%) whom there was progressive biomarker concentrations severity Areas under curve for albumin at 6 surgery 0.84 (95% CI, 0.79-0.89), 0.87 0.83-0.91), 0.76 0.71-0.81), respectively. increasing quartiles lengths hospital stays durations ( P Limitations Single-center study normal function recruitment. SELDI-TOF MS technique has limited sensitivity detection greater than 20-kDa range. Conclusions Urinary represent early, accurate, inexpensive, widely available They also offer prognostic information about duration length hospitalization