Background and aims To investigate the value of urinary neutrophil gelatinase associated lipocalin (NGAL) kidney injury molecular-1 (KIM-1) and interleukin-18 (IL-18) in the diagnosis of acute kidney injury (AKI) following childhood cardiopulmonary bypass (CPB).
Methods 67 patients accepted CPB assigned to acute kidney injury group (group AKI) ornon-acute kidney injury group (group non-AKI). Samples were taken regularly after CPB 30 min, 2 h, 4 h, 24 h, 48 h and 72 h.
Results The incidence of AKI was 34%, including 15 cases with Risk stage AKI, 4 cases with Injury stage AKI, 3 cases with Failure stage AKI, 1 cases with Loss stage AKI. Comparing with the non-AKI group, the levels of urinary NGAL/Cr was much higher than that of controls after CPB 24 h. The levels of urinary NGAL/Cr were higher than that of controls after CPB 48 h. The values for the AUC were determined for urine KIM-1 as 0.698 and 0.662 after CPB 24 h and 48 h. Comparing with the pre-operation, the levels of urinary IL-18/Cr were higher than that of controls after CPB 30 min. AKI group has a higher level than that of non-AKI group after CPB 4 h.
Conclusion In this study, our results identify that possibly urine NGAL, KIM-1 and IL-18 are more significative than Scr for early detection. However, the exact clinical value needs to be further elucidated.