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Difficult Decisions in Cardiothoracic Critical Care Surgery pp 525–545Cite as

Role of Biomarkers in Predicting AKI in the CT ICU

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Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

Abstract

Acute kidney injury (AKI) is one of the most common complications following cardiothoracic surgery and is independently associated with increased morbidity and mortality. Serum creatinine and urine output, the current gold standards, do not provide effective early risk stratification which has led to intense investigation of several novel biomarkers of AKI. This chapter will discuss the literature around pre and post-operative biomarkers of cardiothoracic surgery associated AKI focusing on several novel assays including Neutrophil Gelatinase Associated Lipocalin (NGAL) and Tissue injury metalloprotease-2 insulin-like growth factor binding protein-7 (TIMP2-IGFBP7). We discuss the wealth of prospective observational data that demonstrates these biomarkers can accurately detect AKI and the need for renal replacement therapy earlier than serum creatinine. Additionally, we will discuss the clinical utility and interpretation of these tests as well as discuss the limited randomized data demonstrates that utilizing elevated post-operative biomarkers, prior to a rise in serum creatinine, to trigger a nephrology-focused care bundle can improve outcomes following cardiac surgery.

COI – JLK reports receiving funds from Astute Medical, Abbvie and Bioporto for the enrollment of patients into cardiac surgery associated acute kidney injury clinical studies. JLK has received consulting fees from Astute Medical and Sphingotec.

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Authors and Affiliations

  1. Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA

    Jay L. Koyner

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  1. Jay L. Koyner
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Correspondence to Jay L. Koyner .

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Editors and Affiliations

  1. University of Chicago Medicine, Chicago, IL, USA

    Vassyl A. Lonchyna

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Koyner, J.L. (2019). Role of Biomarkers in Predicting AKI in the CT ICU. In: Lonchyna, V. (eds) Difficult Decisions in Cardiothoracic Critical Care Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-04146-5_36

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  • DOI: https://doi.org/10.1007/978-3-030-04146-5_36

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04145-8

  • Online ISBN: 978-3-030-04146-5

  • eBook Packages: MedicineMedicine (R0)

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