Early prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patients

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dc.contributor.authorBurra, Vijithaen_US
dc.contributor.authorNagaraja, PSen_US
dc.contributor.authorSingh, Naveen Gen_US
dc.contributor.authorPrabhakar, Ven_US
dc.contributor.authorManjunatha, Nen_US
dc.date.accessioned2019-12-02T09:43:42Z
dc.date.available2019-12-02T09:43:42Z
dc.date.issued2018-10
dc.description.abstractBackground: Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI. Therefore, we tested role of serum phosphorus in prediction of AKI as a biomarker after cardiac surgery in children. Methodology: We prospectively evaluated 51 children aged between 3 weeks and 12 years undergoing elective cardiac surgery. Serum creatinine and phosphorus were measured preoperatively and postoperatively at 24 and 48 h. As per the Kidney Disease Improving Global Outcomes criteria, patients were grouped into AKI and non-AKI on the basis of the development of AKI within 48 h postsurgery. The postoperative diagnostic performance of phosphorus thresholds was analyzed by the area under receiver operating characteristic curves (AUC-ROC). Results: From 51 children included, 10 developed AKI. In AKI group, serum phosphorus increased significantly from 4.47 ± 0.43 baseline to 6.29 ± 0.32 at 24 h postsurgery (P = 0.01) while serum creatinine increased from baseline 0.33 (0.24–0.46) to 0.49 (0.26–0.91) at 24 h which is statistically insignificant (P = 0.16). ROC analysis showed that serum phosphorus at 24 h, the AUC was 0.84 with sensitivity 0.75 and specificity 0.93 for a cutoff value of 6.4 mg/dl. Whereas serum phosphorus at 48 h, the AUC was 0.86 with sensitivity 66.67% and specificity 97.62% for a cutoff value of 5.4 mg/dl. Conclusion: Serum phosphorus can be an alternative biomarker as early as 24 h for early prediction of AKI in pediatric cardiac surgery.en_US
dc.identifier.affiliationsDepartment of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, Indiaen_US
dc.identifier.citationBurra Vijitha, Nagaraja PS, Singh Naveen G, Prabhakar V, Manjunatha N. Early prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patients. Annals of Cardiac Anaesthesia. 2018 Oct; 21(4): 455-459en_US
dc.identifier.issn0971-9784
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/185775
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber4en_US
dc.relation.volume21en_US
dc.source.urihttps://dx.doi.org/10.4103/aca.ACA_14_18en_US
dc.subjectAcute kidney injuryen_US
dc.subjectbiomarkeren_US
dc.subjectKidney Disease Improving Global Outcomesen_US
dc.subjectphosphorusen_US
dc.titleEarly prediction of acute kidney injury using serum phosphorus as a biomarker in pediatric cardiac surgical patientsen_US
dc.typeJournal Articleen_US
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