TITLE

Liver fatty acid-binding protein as a biomarker of acute kidney injury after cardiac surgery

AUTHOR(S)
Portilla, D.; Dent, C.; Sugaya, T.; Nagothu, K. K.; Kundi, I.; Moore, P.; Noiri, E.; Devarajan, P.
PUB. DATE
February 2008
SOURCE
Kidney International;Feb2008, Vol. 73 Issue 4, p465
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Acute kidney injury (AKI) is a major complication of cardiac bypass surgery. We examined whether levels of liver fatty acid-binding protein (L-FABP) can be an early biomarker for ischemic injury by measuring this protein in the urine of 40 pediatric patients prior to and following cardiopulmonary bypass surgery. AKI was defined as a 50% increase in the serum creatinine from baseline, which was normally not seen until 24–72 h after surgery. Enzyme-linked immunosorbent assay analysis showed increased L-FABP levels (factored for creatinine excretion) of about 94- and 45-fold at 4 and 12 h, respectively, following surgery in the 21 patients who developed AKI with western blot analysis, confirming L-FABP identity. Univariate logistic regression analyses showed that both bypass time and urinary L-FABP were significant independent risk indicators for AKI. After excluding bypass time from the model and using a stepwise multivariate logistic regression analysis, urinary L-FABP levels at 4 h after surgery were an independent risk indicator with the area under the receiver-operating characteristic curve 0.810, sensitivity 0.714, and specificity 0.684 for a 24-fold increase in urinary L-FABP. Our study shows that urinary L-FABP levels represent a sensitive and predictive early biomarker of AKI after cardiac surgery.Kidney International (2008) 73, 465–472; doi:10.1038/sj.ki.5002721; published online 19 December 2007
ACCESSION #
28724604

 

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