PMID- 31638137
OWN - NLM
STAT- MEDLINE
DCOM- 20210129
LR  - 20210129
IS  - 2175-8239 (Electronic)
IS  - 0101-2800 (Print)
IS  - 0101-2800 (Linking)
VI  - 42
IP  - 1
DP  - 2020 Mar
TI  - Urine microscopy as a biomarker of Acute Kidney Injury following cardiac surgery 
      with cardiopulmonary bypass.
PG  - 18-23
LID - S0101-28002019005031101 [pii]
AB  - INTRODUCTION: Acute kidney injury (AKI) occurs in about 22% of the patients 
      undergoing cardiac surgery and 2.3% requires renal replacement therapy (RRT). The 
      current diagnostic criteria for AKI by increased serum creatinine levels have 
      limitations and new biomarkers are being tested. Urine sediment may be considered 
      a biomarker and it can help to differentiate pre-renal (functional) from renal 
      (intrinsic) AKI. AIMS: To investigate the microscopic urinalysis in the AKI 
      diagnosis in patients undergoing cardiac surgery with cardiopulmonary bypass. 
      METHODS: One hundred and fourteen patients, mean age 62.3 years, 67.5 % male, 
      with creatinine 0.91 mg/dL (SD 0.22) had a urine sample examined in the first 24 
      h after the surgery. We looked for renal tubular epithelial cells (RTEC) and 
      granular casts (GC) and associated the results with AKI development as defined by 
      KDIGO criteria. RESULTS: Twenty three patients (20.17 %) developed AKI according 
      to the serum creatinine criterion and 76 (66.67 %) by the urine output criterion. 
      Four patients required RRT. Mortality was 3.51 %. The use of urine creatinine 
      criterion to predict AKI showed a sensitivity of 34.78 % and specificity of 86.81 
      %, positive likelihood ratio of 2.64 and negative likelihood ratio of 0.75, 
      AUC-ROC of 0.584 (95%CI: 0.445-0.723). For the urine output criterion sensitivity 
      was 23.68 % and specificity 92.11 %, AUC-ROC was 0.573 (95%CI: 0.465-0.680). 
      CONCLUSION: RTEC and GC in urine sample detected by microscopy is a highly 
      specific biomarker for early AKI diagnosis after cardiac surgery.
FAU - Goldani, Joao Carlos
AU  - Goldani JC
AD  - Departamento de Nefrologia, Santa Casa de Misericordia de Porto Alegre, Porto 
      Alegre, RS, Brazil.
FAU - Poloni, Jose Antonio
AU  - Poloni JA
AD  - Laboratorio de Analises Clinicas Carlos Franco Voegeli, Santa Casa de 
      Misericordia de Porto Alegre, Porto Alegre, RS, Brazil.
FAU - Klaus, Fabiano
AU  - Klaus F
AD  - Departamento de Nefrologia, Santa Casa de Misericordia de Porto Alegre, Porto 
      Alegre, RS, Brazil.
FAU - Kist, Roger
AU  - Kist R
AD  - Departamento de Nefrologia, Santa Casa de Misericordia de Porto Alegre, Porto 
      Alegre, RS, Brazil.
FAU - Pacheco, Larissa Sgaria
AU  - Pacheco LS
AD  - Departamento de Nefrologia, Santa Casa de Misericordia de Porto Alegre, Porto 
      Alegre, RS, Brazil.
FAU - Keitel, Elizete
AU  - Keitel E
AD  - Departamento de Nefrologia, Santa Casa de Misericordia de Porto Alegre, Porto 
      Alegre, RS, Brazil.
LA  - por
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20191021
PL  - Brazil
TA  - J Bras Nefrol
JT  - Jornal brasileiro de nefrologia
JID - 9426946
RN  - 0 (Biomarkers)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Acute Kidney Injury/diagnosis/epidemiology/*etiology/*urine
MH  - Aged
MH  - Biomarkers/urine
MH  - Cardiac Surgical Procedures/*adverse effects/methods
MH  - Cardiopulmonary Bypass/*adverse effects
MH  - Creatinine/blood/urine
MH  - Early Diagnosis
MH  - Epithelial Cells/*pathology
MH  - Female
MH  - Humans
MH  - Kidney Function Tests
MH  - Kidney Tubules/*pathology
MH  - Male
MH  - Microscopy, Phase-Contrast/methods
MH  - Middle Aged
MH  - Portugal/epidemiology
MH  - Postoperative Complications/diagnosis/*urine
MH  - Prospective Studies
PMC - PMC7213937
EDAT- 2019/10/23 06:00
MHDA- 2021/01/30 06:00
PMCR- 2020/01/01
CRDT- 2019/10/23 06:00
PHST- 2018/06/18 00:00 [received]
PHST- 2019/07/25 00:00 [accepted]
PHST- 2019/10/23 06:00 [pubmed]
PHST- 2021/01/30 06:00 [medline]
PHST- 2019/10/23 06:00 [entrez]
PHST- 2020/01/01 00:00 [pmc-release]
AID - S0101-28002019005031101 [pii]
AID - 10.1590/2175-8239-JBN-2018-0133 [doi]
PST - ppublish
SO  - J Bras Nefrol. 2020 Mar;42(1):18-23. doi: 10.1590/2175-8239-JBN-2018-0133. Epub 
      2019 Oct 21.