INFLAMMATORY BIOMARKERS & ACUTE RENAL FAILURE IN CARDIOPULMONARY BYPASS SURGERY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 急性肾损伤(AKI)与大量的死亡率有关，尤其是发生在重症监护室或心脏搭桥术后。到目前为止，所有预防或治疗AKI的治疗干预都失败了。在一定程度上，这一失败是由于AKI诊断较晚。这是根据血清肌酐的升高来诊断的。当这种情况发生时，实质性的伤害已经发生，治疗很可能不成功。在保护肾脏的干预措施有希望取得成功的最早阶段，迫切需要诊断AKI的方法。我们的目标是确定一种新的近端肾小管损伤的尿液生物标志物(腺苷脱氨酶结合蛋白-26)是否可以在检测到血清肌酐升高之前检测出有临床意义的急性肾损伤。此外，我们的目标是确定在接受体外循环手术的患者中促炎症细胞因子(IL-1B、IL-6和TNF-a)的时间分布，并比较发生急性肾损伤和未发生肾损伤的患者的这些分布。最后，我们的目标是发现新的尿液生物标志物，可以区分AKI和与AKI无关的血清肌酐升高。这些生物标志物将被用来定义AKI的早期事件，并允许在肾脏损伤的最早迹象时进行治疗。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acute kidney injury (AKI) is associated with substantial mortality, expecially when it occurs in the intensive care unit or post-cardiac bypass surgery. Thus far all therapeutic interventions to either prevent or treat AKI have failed. In part, this failure is due to late diagnosis of AKI. which is diagnosed based upon the rise in serum creatinine. When this occurs, substantial injury has already taken place and therapies are likely to be unsuccessful. There is great need for methods of diagnosis AKI at the very earliest stages when there is hope that interventions to protect the kidney may be successful. We aim to determine if a novel urinary biomarker of proximal tubular injury (adenosine deaminase binding protein-26) can detect clinical meaningful acute kidney injury before rises in serum creatinine are detectable. Furthermore, we aim to determine the temporal profile of pro-inflammatory cytokines (IL-1B, IL-6, and TNF-a) in patients undergoing cardiopulmonary bypass surgery and compare these profiles between patients developing acute kidney injury and those who do not develop kidney injury. Lastly, we aim to discover novel urinary biomarkers that can discriminate between AKI and rises in serum creatinine that are not associated with AKI. These biomarkers will be used to define the early events of AKI and allow for therapy at the earliest signs of renal injury.