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Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery

BACKGROUND: Quantification of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein (IFGBP-7), which is commercially known as NephroCheck™(NC) test have been suggested as promising tools for the early detection of acute kidney injury (AKI) after card...

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Autores principales: Kanchi, Muralidhar, Sudheshna, Karanam D, Damodaran, Srinath, Gunaseelan, Vikneswaran, Varghese, Anup D, Belani, Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997466/
https://www.ncbi.nlm.nih.gov/pubmed/36722589
http://dx.doi.org/10.4103/aca.aca_56_21
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author Kanchi, Muralidhar
Sudheshna, Karanam D
Damodaran, Srinath
Gunaseelan, Vikneswaran
Varghese, Anup D
Belani, Kumar
author_facet Kanchi, Muralidhar
Sudheshna, Karanam D
Damodaran, Srinath
Gunaseelan, Vikneswaran
Varghese, Anup D
Belani, Kumar
author_sort Kanchi, Muralidhar
collection PubMed
description BACKGROUND: Quantification of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein (IFGBP-7), which is commercially known as NephroCheck™(NC) test have been suggested as promising tools for the early detection of acute kidney injury (AKI) after cardiac surgery involving cardio-pulmonary bypass (CPB). OBJECTIVES: The aim of the present study was to test the hypothesis that single value of postoperative NC test performed at 4 hours after surgery can predict AKI in off-pump coronary artery bypass grafting (OPCABG) surgery. SETTING AND DESIGN: This prospective single-center study was conducted at the tertiary cardiac center in India from December 2017 to November 2018. METHODS: Ninety adult patients of both sex undergoing elective OPCABG were included. Anesthesia was standardized to all patients. Urine samples were collected preoperatively and at 4 hours after surgery for NC test. Urine output, serum creatinine, estimated glomerular filtration rate (eGFR) were also measured. AKI staging was based on kidney disease improving global outcomes (KDIGO) guidelines. STATISTICAL ANALYSIS: To assess the predictability of NC test for the primary endpoint, area under the receiver operating characteristic curve (ROC), was calculated. RESULTS: Thirteen patients developed AKI in the study cohort (14.4%) out of which 7 patients (7.8%) developed stage 2/3 AKI and the remaining stage 1 AKI. Baseline renal parameters were similar between AKI and non-AKI group. The area under curve (AUC) of NC test at 4 hours after surgery was 0.60 [95% confidence interval (CI): 0.42-0.77]. Postoperative NC test performed at 4 hours after surgery did not predict AKI in this study population (P = 0.24). There were no significant differences in duration of mechanical ventilation, length of intensive care stay and hospital stay between the two groups (P > 0.05). CONCLUSION: NephroCheck™ test performed at 4 hours after surgery did not identify patients at risk for developing AKI following OPCABG surgery.
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spelling pubmed-99974662023-03-10 Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery Kanchi, Muralidhar Sudheshna, Karanam D Damodaran, Srinath Gunaseelan, Vikneswaran Varghese, Anup D Belani, Kumar Ann Card Anaesth Original Article BACKGROUND: Quantification of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein (IFGBP-7), which is commercially known as NephroCheck™(NC) test have been suggested as promising tools for the early detection of acute kidney injury (AKI) after cardiac surgery involving cardio-pulmonary bypass (CPB). OBJECTIVES: The aim of the present study was to test the hypothesis that single value of postoperative NC test performed at 4 hours after surgery can predict AKI in off-pump coronary artery bypass grafting (OPCABG) surgery. SETTING AND DESIGN: This prospective single-center study was conducted at the tertiary cardiac center in India from December 2017 to November 2018. METHODS: Ninety adult patients of both sex undergoing elective OPCABG were included. Anesthesia was standardized to all patients. Urine samples were collected preoperatively and at 4 hours after surgery for NC test. Urine output, serum creatinine, estimated glomerular filtration rate (eGFR) were also measured. AKI staging was based on kidney disease improving global outcomes (KDIGO) guidelines. STATISTICAL ANALYSIS: To assess the predictability of NC test for the primary endpoint, area under the receiver operating characteristic curve (ROC), was calculated. RESULTS: Thirteen patients developed AKI in the study cohort (14.4%) out of which 7 patients (7.8%) developed stage 2/3 AKI and the remaining stage 1 AKI. Baseline renal parameters were similar between AKI and non-AKI group. The area under curve (AUC) of NC test at 4 hours after surgery was 0.60 [95% confidence interval (CI): 0.42-0.77]. Postoperative NC test performed at 4 hours after surgery did not predict AKI in this study population (P = 0.24). There were no significant differences in duration of mechanical ventilation, length of intensive care stay and hospital stay between the two groups (P > 0.05). CONCLUSION: NephroCheck™ test performed at 4 hours after surgery did not identify patients at risk for developing AKI following OPCABG surgery. Wolters Kluwer - Medknow 2023 2023-01-03 /pmc/articles/PMC9997466/ /pubmed/36722589 http://dx.doi.org/10.4103/aca.aca_56_21 Text en Copyright: © 2023 Annals of Cardiac Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kanchi, Muralidhar
Sudheshna, Karanam D
Damodaran, Srinath
Gunaseelan, Vikneswaran
Varghese, Anup D
Belani, Kumar
Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery
title Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery
title_full Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery
title_fullStr Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery
title_full_unstemmed Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery
title_short Single Value of NephroCheck™ Performed at 4 Hours After Surgery Does Not Predict Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery
title_sort single value of nephrocheck™ performed at 4 hours after surgery does not predict acute kidney injury in off-pump coronary artery bypass surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997466/
https://www.ncbi.nlm.nih.gov/pubmed/36722589
http://dx.doi.org/10.4103/aca.aca_56_21
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