Vijitha Burra
Sri jayadeva institute of cardiovascular sciences and research, Bangalore
Title: Acute kidney injury prediction in paediatric cardiac surgery patients with phosphorus as simple biomarker
Biography
Biography: Vijitha Burra
Abstract
BACKGROUND
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 3mo-12yrs undergoing elective cardiac surgery. Serum creatinine and phosphorus were measured preoperatively and postoperatively at 24,48hrs. As per KDIGO (Kidney Disease Improving Global Outcome) criteria ,patients were grouped into AKI and NON AKI on basis of development of AKI within 48hrs postsurgery .The postoperative diagnostic performance of phosphorus thresholds were analysed 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±1.36 baseline to 6.29±1.01 at 24hrs postsurgery (p=0.003).While serum creatinine increased from baseline 0.36±0.19 to 0.74±0.90 at 24hrs which is insignificant (p=0.14).Receiver Operating Characteristic Curve analysis showed that serum phosphorus at 24hrs, the area under the curve was 0.84 with sensitivity 0.75, specificity 0.93 for a cut off value of 6.4mg/dl. Whereas serum phosphorus at 48hrs, the area under the curve was 0.86 with sensitivity 66.67% and specificity 97.62% for a cut off value of 5.4 mg/dl.
CONCLUSION
Serum phosphorus can be an alternative biomarker as early as 24hrs for early prediction of AKI in paediatric cardiac surgery.