Table 3.
Summary of serum biomarkers for CPB-associated AKI.
| Novel biomarkers | Significance | Reference |
|---|---|---|
| Serum cystatin C | The 12 h cystatin C strongly correlated with severity and duration of AKI as well as length of hospital stay. In multivariable analysis, 12 h cystatin C remained a powerful independent predictor of AKI. The discriminatory capacity of plasma cystatin C measured preoperatively and 2 hours after the conclusion of CPB was modest. | [126] |
| Serum ADMA | Patients with elevated ADMA before surgery were more likely to have prolonged mechanical ventilation, develop LCOS, require an extended length of stay, and require reoperation. ADMA levels inversely correlated with eGFR, but did not predict AKI. Preoperative serum ADMA appears to identify pediatric cardiac surgery patients at risk of poor postoperative outcomes following CPB. | [127] |
| Plasma fHb | During surgery, plasma fHb increased in patients with AKI, reaching peak levels at 2 h after reperfusion. | [89] |
| Serum vasopressinase activity | For patients undergoing CPB surgery, their serum vasopressinase activity peaks at the time of arrival to the ICU. In patients who were diagnosed with AKI, serum vasopressinase activity peaked 30 minutes into CPB. | [125] |
| Plasma micro-RNAs and microvesicle | A number of micro-RNAs (miR-192-5p, miR-487a-3p, miR-490-3p, and miR-501-3p) and microvesicles were differentially expressed in AKI children at 6–12 h following CPB, which might serve as tools for stratification of children at risk of AKI. | [128] |
| Serum miR-494 | Serum level of miR-494 in the death group due to AKI was more than fourfold higher than that in the survival group. Furthermore, its level was identified as an independent risk factor for death due to CPB-associated AKI. | [129] |
| Serum NGAL | The serum levels of NGAL in the death group were significantly higher than those in the survival group. Furthermore, the expression level of serum NGAL was positively correlated with that of miR-494 in the death group. | [129] |
| Serum KIM-1 | The serum levels of KIM-1 in the death group were significantly higher than those in the survival group. The expression level of serum KIM-1 was positively correlated with that of miR-494 in the death group. | [129] |
ADMA: asymmetrical dimethylarginine; LCOS: low cardiac output syndrome; eGFR: estimated glomerular filtration rate; fHb: free hemoglobin; NGAL: neutrophil gelatinase-associated lipocalin; KIM: kidney injury molecule.