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Diagnosis of cardiac surgery-associated acute kidney injury from functional to damage biomarkers

Wim Vandenberghe (UGent) , Jorien De Loor (UGent) and Eric Hoste (UGent)
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Abstract
Purpose of review : Acute kidney injury (AKI) occurs in up to 30% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice. Recent findings : We present an updated review on the use of blood and urinary NGAL in CSA-AKI. NGAL is a good predictor, and performs better in children than adults. There is a large variation in predictive ability, possibly caused by diversity of AKI definitions used, different time of measurement of NGAL, and lack of specificity of NGAL assays. Similarly, there are conflicting data on the predictive ability of urinary [TIMP-2] [IGFBP7] for CSA-AKI. Recently, both for NGAL and for urinary [TIMP-2] [IGFBP7], a set of actions, based on pretest assessment of risk for CSA-AKI and biomarker test results, was developed. These scores should be evaluated in prospective trials. Summary : NGAL and urinary [TIMP-2] [IGFBP7], in combination with pretest assessment, are promising tools for early detection and treatment in CSA-AKI.
Keywords
[TIMP-2] [IGFBP7], acute kidney injury, biomarkers, cardiac surgery, cardiac surgery-associated acute kidney injury, NGAL, GELATINASE-ASSOCIATED LIPOCALIN, CRITICALLY-ILL PATIENTS, CELL-CYCLE ARREST, CARDIOPULMONARY BYPASS-SURGERY, LONG-TERM SURVIVAL, ACUTE RENAL INJURY, SERUM URIC-ACID, URINARY BIOMARKERS, CYSTATIN-C, SUBCLINICAL AKI

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Citation

Please use this url to cite or link to this publication:

Chicago
Vandenberghe, Wim, Jorien De Loor, and Eric Hoste. 2017. “Diagnosis of Cardiac Surgery-associated Acute Kidney Injury from Functional to Damage Biomarkers.” Current Opinion in Anaesthesiology 30 (1): 66–75.
APA
Vandenberghe, Wim, De Loor, J., & Hoste, E. (2017). Diagnosis of cardiac surgery-associated acute kidney injury from functional to damage biomarkers. CURRENT OPINION IN ANAESTHESIOLOGY, 30(1), 66–75.
Vancouver
1.
Vandenberghe W, De Loor J, Hoste E. Diagnosis of cardiac surgery-associated acute kidney injury from functional to damage biomarkers. CURRENT OPINION IN ANAESTHESIOLOGY. 2017;30(1):66–75.
MLA
Vandenberghe, Wim, Jorien De Loor, and Eric Hoste. “Diagnosis of Cardiac Surgery-associated Acute Kidney Injury from Functional to Damage Biomarkers.” CURRENT OPINION IN ANAESTHESIOLOGY 30.1 (2017): 66–75. Print.
@article{8506963,
  abstract     = {Purpose of review : Acute kidney injury (AKI) occurs in up to 30\% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice. 
Recent findings : We present an updated review on the use of blood and urinary NGAL in CSA-AKI. NGAL is a good predictor, and performs better in children than adults. There is a large variation in predictive ability, possibly caused by diversity of AKI definitions used, different time of measurement of NGAL, and lack of specificity of NGAL assays. Similarly, there are conflicting data on the predictive ability of urinary [TIMP-2] [IGFBP7] for CSA-AKI. Recently, both for NGAL and for urinary [TIMP-2] [IGFBP7], a set of actions, based on pretest assessment of risk for CSA-AKI and biomarker test results, was developed. These scores should be evaluated in prospective trials. 
Summary : NGAL and urinary [TIMP-2] [IGFBP7], in combination with pretest assessment, are promising tools for early detection and treatment in CSA-AKI.},
  author       = {Vandenberghe, Wim and De Loor, Jorien and Hoste, Eric},
  issn         = {0952-7907},
  journal      = {CURRENT OPINION IN ANAESTHESIOLOGY},
  keyword      = {[TIMP-2] [IGFBP7],acute kidney injury,biomarkers,cardiac surgery,cardiac surgery-associated acute kidney injury,NGAL,GELATINASE-ASSOCIATED LIPOCALIN,CRITICALLY-ILL PATIENTS,CELL-CYCLE ARREST,CARDIOPULMONARY BYPASS-SURGERY,LONG-TERM SURVIVAL,ACUTE RENAL INJURY,SERUM URIC-ACID,URINARY BIOMARKERS,CYSTATIN-C,SUBCLINICAL AKI},
  language     = {eng},
  number       = {1},
  pages        = {66--75},
  title        = {Diagnosis of cardiac surgery-associated acute kidney injury from functional to damage biomarkers},
  url          = {http://dx.doi.org/10.1097/aco.0000000000000419},
  volume       = {30},
  year         = {2017},
}

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