Plasma Neutrophil Gelatinase-Associated Lipocalin Is Associated With Acute Kidney Injury and Clinical Outcomes in Neonates Undergoing Cardiopulmonary Bypass. Issue 10 (October 2019) - Schroeder, Luke W.
Abstract : Objectives: Acute kidney injury is a frequent complication following neonatal cardiac surgery and is associated with significant morbidity and mortality. The objectives of this study were to determine if plasma neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury and clinical outcomes in neonates with congenital heart disease undergoing cardiopulmonary bypass. Design: Retrospective single-center observational study. Setting: A pediatric cardiac ICU within a tertiary-care academic hospital. Patients: Patients age less than 30 days undergoing cardiac surgery requiring cardiopulmonary bypass. Interventions: None. Measurements and Main Results: Plasma neutrophil gelatinase-associated lipocalin peaked at 12 hours postcardiopulmonary bypass and more than doubled compared with preoperative levels. Higher preoperative and 24-hour postoperative neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury ( r = 0.30, r = 0.49), longer duration of mechanical ventilation ( r = 0.40, r = 0.51), ICU ( r = 0.32, r = 0.33) and hospital lengths of stay ( r = 0.28, r = 0.32), and total hospital charges ( r = 0.35, r = 0.30; all p values < 0.05). Conclusions: Both preoperative and 24-hour postoperative plasma neutrophil gelatinase-associated lipocalin levels are associated with acute kidney injury and worse clinical outcomes in neonates undergoing cardiac surgery. Plasma neutrophil gelatinase-associated lipocalin levels may have a role in risk stratification for predicting postoperative renal dysfunction as well as providing a potential clinical trajectory in the postoperative period.