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. 2024 Dec;39(12):3591-3596.
doi: 10.1007/s00467-024-06464-9. Epub 2024 Aug 2.

Urine dipstick blood and acute kidney injury in infants undergoing cardiopulmonary bypass

Amy E Strong  1   2 , Jarcy Zee  3   4 , Benjamin L Laskin  5   6 , Kathryn Howarth  5 , Joshua Blinder  7 , Elizabeth A Chrischilles  8 , Daniella Levy Erez  5   9   10 , Michelle R Denburg  5   4   6
Affiliations

Urine dipstick blood and acute kidney injury in infants undergoing cardiopulmonary bypass

Amy E Strong et al. Pediatr Nephrol. 2024 Dec.

Abstract

Background: Cardiopulmonary bypass (CPB) is associated with hemolysis and acute kidney injury (AKI). The study aim was to determine if urine dipstick blood in infants after CPB was associated with AKI and urine neutrophil gelatinase-associated lipocalin (NGAL).

Methods: Infants who underwent CPB at a single center were enrolled prospectively between October 2017 and June 2019. Urine samples prior to CPB and 6 h after CPB cessation were analyzed in batch for NGAL and dipstick blood. AKI was defined using creatinine-based KDIGO criteria within 72 h of CPB. Spearman correlation examined associations between urine dipstick blood and NGAL at each time point. Linear regression estimated the associations between urine dipstick blood and log-transformed NGAL 6 h after CPB. Logistic regression estimated associations and compared discrimination between urine dipstick blood and NGAL for predicting AKI.

Results: At baseline, 7/63 samples (11%) had > trace blood. Six hours after CPB, 62/98 samples (63%) had > trace blood and 26% had 3 + (large) blood. In total, 18/98 (18%) with a 6-h post-CPB sample had postoperative AKI. Urine dipstick blood values correlated with urine NGAL 6 h after CPB (r = 0.52, p < 0.01), but not at baseline (r = 0.06, p = 0.66). Those with 3 + (large) blood on urine dipstick had 6 times higher mean NGAL values compared to those with negative/trace blood (mean ratio 6.6, 95%CI 3.1-14.4, p < 0.01). Those with 3 + (large) blood had 8 times higher odds of AKI (OR 7.99, 95%CI 1.5-41.9, p = 0.01).

Conclusions: Urine dipstick blood post CPB may be a simple and inexpensive tool to help predict AKI in infants.

Keywords: AKI; Cardiopulmonary bypass; Hemolysis; Infants; Urine dipstick.

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Conflict of interest statement

Statements & Declarations

Competing interests: MD had research funding from Mallinckrodt Pharmaceuticals (not related to this work) ending in December 2021. The remaining authors have no COI to disclose.

Figures

Figure 1:
Figure 1:. Urine Dipstick Blood Results by Time Point
See this image and copyright information in PMC

References

    1. Lee SH, Kim SJ, Kim HJ, Son JS, Lee R, Yoon TG (2017) Acute Kidney Injury Following Cardiopulmonary Bypass in Children-Risk Factors and Outcomes. Circ J 81:1522–1527. - PubMed
    1. Blinder JJ, Goldstein SL, Lee V-V, Baycroft A, Fraser CD, Nelson D, Jefferies JL (2012) Congenital heart surgery in infants: Effects of acute kidney injury on outcomes. The Journal of Thoracic and Cardiovascular Surgery 143:368–374. - PubMed
    1. Aydin SI, Seiden HS, Blaufox AD, Parnell VA, Choudhury T, Punnoose A, Schneider J (2012) Acute kidney injury after surgery for congenital heart disease. Ann Thorac Surg 94:1589–1595. - PubMed
    1. Alabbas A, Campbell A, Skippen P, Human D, Matsell D, Mammen C (2013) Epidemiology of cardiac surgery-associated acute kidney injury in neonates: a retrospective study. Pediatr Nephrol 28:1127–1134. - PubMed
    1. Tóth R, Breuer T, Cserép Z, Lex D, Fazekas L, Sápi E, Szatmári A, Gál J, Székely A (2012) Acute kidney injury is associated with higher morbidity and resource utilization in pediatric patients undergoing heart surgery. Ann Thorac Surg 93:1984–1990. - PubMed

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