TY - JOUR
T1 - Urinary biomarkers to predict severe fluid overload after cardiac surgery
T2 - A pilot study
AU - Elitok, Saban
AU - Isermann, Berend
AU - Westphal, Sabine
AU - Devarajan, Prasad
AU - Albert, Christian
AU - Kuppe, Hermann
AU - Ernst, Martin
AU - Bellomo, Rinaldo
AU - Haase, Michael
AU - Haase-Fielitz, Anja
N1 - Funding Information:
This work was supported by grants from the German Heart Foundation (Deutsche Stiftung für Herzforschung) and from the Else Kröner-Fresenius-Stiftung, Germany. The sponsors have not been involved in the study design; the collection, analysis and interpretation of data; the writing of the report; and the decision to submit the article for publication. M Haase has received honoraria speaking for Abbott Diagnostics, Alere, Astute Medical, Biosite, Inc., and Siemens Healthineers. All companies are involved in the development and marketing of renal biomarkers. C Albert has received honoraria speaking for Siemens Healthineers. P Devarajan is a co-inventor on patents submitted for the use of NGAL as a biomarker of kidney disease. Mentioned companies have not been involved in the study design; the collection, analysis and interpretation of data; the writing of the report; and the decision to submit the article for publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.
Publisher Copyright:
© 2021 Future Medicine Ltd.
PY - 2021/11
Y1 - 2021/11
N2 - Aim: To assess the predictive ability of urinary and plasma biomarkers and clinical routine parameters for subsequent severe fluid overload. Patients & methods: In a pilot study, we studied 100 adult patients after cardiac surgery. On intensive care unit admission, we measured biomarkers in urine (midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL], hepcidin-25) and plasma (creatinine, urea, B-type natriuretic peptide, lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin-25) to predict postoperative severe fluid overload. Results: Urinary midkine, IL-6, NGAL and hepcidin-25 (all AUCs =0.79) predicted postoperative severe fluid overload (n = 5 patients). Urinary NGAL/hepcidin-25 ratio (AUC 0.867) predicted postoperative severe fluid overload after adjustment to EuroScore and need for norepinephrine on surgery day (odds ratio: 2.4). Conclusion: Urinary biomarkers on intensive care unit admission might be helpful to predict subsequent severe fluid overload after cardiac surgery. Lay abstract: Aim: To assess whether proteins in the urine or blood or clinical routine laboratory parameters can predict severe body fluid overload after cardiac surgery. Patients & methods: In a pilot study, we studied 100 adult patients after cardiac surgery. After surgery, we measured proteins in the urine (midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL], hepcidin-25) and blood (creatinine, urea, B-type natriuretic peptide, lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin- 25) to predict postoperative severe fluid overload. Results: Urinary midkine, IL-6, NGAL and hepcidin- 25 predicted postoperative severe fluid overload (n = 5 patients). Urinary NGAL/hepcidin-25 ratio predicted postoperative severe fluid overload after adjustment to important covariates. Conclusion: Urinary biomarkers might be helpful to predict subsequent severe fluid overload after cardiac surgery. Tweetable abstract In a pilot study with 100 adult patients after cardiac surgery, we found that urinary biomarkers, but not blood biomarkers can help predict postoperative severe fluid overload after cardiac surgery.
AB - Aim: To assess the predictive ability of urinary and plasma biomarkers and clinical routine parameters for subsequent severe fluid overload. Patients & methods: In a pilot study, we studied 100 adult patients after cardiac surgery. On intensive care unit admission, we measured biomarkers in urine (midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL], hepcidin-25) and plasma (creatinine, urea, B-type natriuretic peptide, lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin-25) to predict postoperative severe fluid overload. Results: Urinary midkine, IL-6, NGAL and hepcidin-25 (all AUCs =0.79) predicted postoperative severe fluid overload (n = 5 patients). Urinary NGAL/hepcidin-25 ratio (AUC 0.867) predicted postoperative severe fluid overload after adjustment to EuroScore and need for norepinephrine on surgery day (odds ratio: 2.4). Conclusion: Urinary biomarkers on intensive care unit admission might be helpful to predict subsequent severe fluid overload after cardiac surgery. Lay abstract: Aim: To assess whether proteins in the urine or blood or clinical routine laboratory parameters can predict severe body fluid overload after cardiac surgery. Patients & methods: In a pilot study, we studied 100 adult patients after cardiac surgery. After surgery, we measured proteins in the urine (midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL], hepcidin-25) and blood (creatinine, urea, B-type natriuretic peptide, lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin- 25) to predict postoperative severe fluid overload. Results: Urinary midkine, IL-6, NGAL and hepcidin- 25 predicted postoperative severe fluid overload (n = 5 patients). Urinary NGAL/hepcidin-25 ratio predicted postoperative severe fluid overload after adjustment to important covariates. Conclusion: Urinary biomarkers might be helpful to predict subsequent severe fluid overload after cardiac surgery. Tweetable abstract In a pilot study with 100 adult patients after cardiac surgery, we found that urinary biomarkers, but not blood biomarkers can help predict postoperative severe fluid overload after cardiac surgery.
KW - biomarker
KW - cardiac surgery
KW - cardiopulmonary bypass
KW - cardiorenal syndrome
KW - fluid overload
KW - heart
KW - IL-6
KW - kidney
KW - midkine
KW - NGAL/hepcidin ratio
UR - http://www.scopus.com/inward/record.url?scp=85119212458&partnerID=8YFLogxK
U2 - 10.2217/bmm-2021-0283
DO - 10.2217/bmm-2021-0283
M3 - Article
C2 - 34672680
AN - SCOPUS:85119212458
SN - 1752-0363
VL - 15
SP - 1451
EP - 1464
JO - Biomarkers in Medicine
JF - Biomarkers in Medicine
IS - 16
ER -