Cardiac Biomarkers for Risk Stratification of Acute Kidney Injury After Pediatric Cardiac Surgery.
Cardiac Biomarkers for Risk Stratification of Acute Kidney Injury After Pediatric Cardiac Surgery.
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DOI：
10.1016/j.athoracsur.2020.03.010
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Parikh CR
中科院分区：
文献类型：
--
作者：
Greenberg JH;Parsons M;Zappitelli M;Jia Y;Thiessen-Philbrook HR;Devarajan P;Everett AD;Parikh CR
接受心脏外科手术的儿童患急性肾损伤(AKI)的风险增加。需要新的生物标志物来改善心脏手术后急性心肌梗死的风险分层。我们从2007年7月至2010年12月招募了1个月至18岁的儿童接受体外循环手术。在心脏手术前和术后6小时内，检测了美国食品和药物管理局批准的三种血浆生物标志物：心脏牵张、N末端前B型利钠肽(NTproBNP)、炎症(ST2)或纤维化(Galectin-3)。所有分析都按年龄(2岁或≥2岁)分层，以说明儿童时期生物标记物分布的变化，以及由于Galectin-3和NTproBNP的生物标记物与年龄之间的显著交互作用(P<；0.05)。手术后，2岁以下儿童中51例和2岁≥儿童中28例诊断为急性心肌梗死，定义为基线血肌酐增加一倍。经多因素调整后，对于2岁的儿童，没有一种生物标志物与急性肾功能衰竭独立相关，而对于2岁的≥儿童，术前Galectin-3和NTproBNP以及术后Galectin-3和St2的最高水平与急性肾功能不全相关。在2岁的≥儿童中，术前血浆Galectin-3和NTproBNP以及术后首次Galectin-3和St2水平与急性脑梗塞独立相关。心脏外科手术后心脏生物标志物的表现受年龄的影响，需要研究开发适用于儿童和2岁的生物标志物。
Children undergoing a cardiac surgical procedure are at increased risk for acute kidney injury (AKI). Novel biomarkers are needed to improve risk stratification of AKI after cardiac surgery. We enrolled children aged 1 month to 18 years old from July 2007 to December 2010 undergoing cardiopulmonary bypass. Three United States Food and Drug Administration-approved plasma biomarkers of cardiac stretch, N-terminal pro B-type natriuretic peptide (NTproBNP), inflammation (ST2), or fibrosis (galectin-3), were measured preoperatively and postoperatively within 6 hours of cardiac surgery. All analyses were stratified by age (<2 or ≥2 years old) to account for changing biomarker distributions during childhood and due to a significant interaction between biomarker and age for galectin-3 and NTproBNP (P < .05). Postoperatively, AKI, defined by a doubling of baseline serum creatinine, was diagnosed in 51 of 194 children <2 years and in 28 of 201 children ≥2 years. After multivariable adjustment, for children <2 years, none of the biomarkers were independently associated with AKI, whereas for children ≥2 years, the highest tertile of preoperative galectin-3 and NTproBNP as well as the postoperative galectin-3 and ST2 were associated with AKI. Preoperative plasma galectin-3 and NTproBNP and the first postoperative galectin-3 and ST2 levels were independently associated with AKI in children ≥2 years old. The performance of cardiac biomarkers after cardiac surgical procedure is affected by age, and research is required to develop biomarkers for children <2 years old.
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DOI：
10.1007/s00467-014-2989-y
发表时间：
2015-04
期刊：
Pediatric nephrology (Berlin, Germany)
影响因子：
--
作者：
Bennett MR;Nehus E;Haffner C;Ma Q;Devarajan P
通讯作者：
Devarajan P
DOI：
10.1007/s00467-015-3088-4
发表时间：
2015-09
期刊：
Pediatric nephrology (Berlin, Germany)
影响因子：
--
作者：
Greenberg JH;Whitlock R;Zhang WR;Thiessen-Philbrook HR;Zappitelli M;Devarajan P;Eikelboom J;Kavsak PA;Devereaux PJ;Shortt C;Garg AX;Parikh CR;TRIBE-AKI Consortium
通讯作者：
TRIBE-AKI Consortium
DOI：
10.2215/cjn.10971012
发表时间：
2013-07-01
影响因子：
9.8
作者：
Parikh, Chirag R.;Thiessen-Philbrook, Heather;Coca, Steven G.
通讯作者：
Coca, Steven G.
DOI：
10.1007/s00259-006-0179-2
发表时间：
2006-12-01
影响因子：
9.1
作者：
Piepsz, A.;Tondeur, M.;Ham, H.
通讯作者：
Ham, H.
影响因子：
37.8
作者：
Shimpo, M;Morrow, DA;Lee, RT
通讯作者：
Lee, RT