Predictive Biomarker for Cardiac Surgery-Associated Acute Kidney Injury: A Retrospective Analysis

ABSTRACT

Introduction:  Cardiac surgery-associated acute kidney injury (CSA-AKI) is a popular and severe complication after cardiac surgery. We aimed to set up a quick and accurate predictive model for rapid identification of CSA-AKI and to evaluate its predictive value.

Methods:  In this retrospective study, we included a total of 120 patients who underwent heart surgery and divided them into 55 patients who developed kidney injury following heart surgery (CSA-AKI group) and 65 patients who did not experience kidney injury after the same surgical procedure (non-CSA-AKI group). The predictive capacity of various laboratory indicators for CSA-AKI were assessed, including tumor necrosis factor-α (TNF-α), interleukin 2, interleukin 6, and neutrophil gelatinase-associated lipocalin (NGAL). Additionally, receiver operating characteristic curve analysis was employed to evaluate the performance of the model in predicting CSA-AKI.

Results:  After cardiac surgery, patients who developed CSA-AKI exhibited significantly higher levels of TNF-α, interleukin 2, interleukin 6, and NGAL compared to the control group. Receiver operating characteristic curve analysis revealed that TNF-α, interleukin 2, interleukin 6, and NGAL showed good diagnostic performance, with area under the curve values of 0.66, 0.78, 0.66, and 0.80, respectively. Further analysis demonstrated that the combination of TNF-α, interleukin 2, interleukin 6, and NGAL had the highest predictive value for acute kidney injury (area under the curve = 0.93).

Conclusion:  TNF-α, interleukin 2, interleukin 6, and NGAL exhibited a promising predictive capability for CSA-AKI, while a combined diagnostic model was established to enhance the diagnostic value further.

Keywords:
Acute Kidney Injury; Biomarkers; Lipocalin-2; Interleukin-2; Tumor Necrosis Factors; Cardiac Surgical Procedures.