Values of combination of urinary L-FABP and NGAL in early diagnosis of acute kidney injury after cardiac surgery in children

TANG Rong; AO Xiang; ZHONG Yong; WANG Rui-Ling; ZHOU Qiao-Ling

doi:10.7499/j.issn.1008-8830.2017.07.008

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Chinese Journal of Contemporary Pediatrics ›› 2017, Vol. 19 ›› Issue (7) : 770-775. DOI: 10.7499/j.issn.1008-8830.2017.07.008

CLINICAL RESEARCH

Values of combination of urinary L-FABP and NGAL in early diagnosis of acute kidney injury after cardiac surgery in children

TANG Rong, AO Xiang, ZHONG Yong, WANG Rui-Ling, ZHOU Qiao-Ling

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Abstract

Objective To investigate the values of combination of urinary liver-type fatty acid-binding protein (L-FABP) and neutrophil gelatinase-associated lipocalin (NGAL) in early diagnosis of acute kidney injury (AKI) after cardiac surgery in children. Methods A total of 97 children with congenital heart disease undergoing cardiopulmonary bypass surgery were enrolled. Serum and urine samples were collected before and after surgery. Levels of serum creatinine (Scr), urinary L-FABP, and urinary NGAL from AKI group (n=18) and non-AKI group (n=79) were measured, and the postoperative dynamic changes in these markers were compared between the two groups. The receiver operating characteristic (ROC) curve and the area under ROC curve (AUC) were used to assess the values of these markers alone or in combination in the prediction of postoperative AKI. Results The levels of urinary L-FABP and NGAL in the AKI group were signifcantly higher than those in the non-AKI group at 2 and 6 hours after surgery, and the changes in their concentrations were earlier than Scr. The AUCs of urinary L-FABP alone in predicting AKI at 2 and 6 hours after surgery were 0.921 and 0.896 respectively, and those of urinary NGAL alone were 0.908 and 0.928 respectively. Those of their combination were 0.942 and 0.929 respectively. Conclusions Urinary L-FABP and NGAL signifcantly increase in the early stage of AKI after cardiac surgery in children, which are signifcantly earlier than the changes in Scr. They can be used to predict the occurrence of AKI in the early stage. A combination of the two biomarkers can further improve the accuracy of diagnosis.

Key words

Liver-type fatty acid-binding protein / Neutrophil gelatinase-associated lipocalin / Congenital heart disease / Acute kidney injury / Child

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TANG Rong, AO Xiang, ZHONG Yong, WANG Rui-Ling, ZHOU Qiao-Ling. Values of combination of urinary L-FABP and NGAL in early diagnosis of acute kidney injury after cardiac surgery in children[J]. Chinese Journal of Contemporary Pediatrics. 2017, 19(7): 770-775 https://doi.org/10.7499/j.issn.1008-8830.2017.07.008

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