J Korean Med Sci.  2014 Aug;29(8):1102-1107. 10.3346/jkms.2014.29.8.1102.

Acute Kidney Injury after Using Contrast during Cardiac Catheterization in Children with Heart Disease

• Hwang YJ
• Hyun MC
• Choi BS
• Chun SY
• Cho MH

• KMID: 2129605
• DOI: http://doi.org/10.3346/jkms.2014.29.8.1102

Abstract

Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery.

Keyword

Acute Kidney Injury; Kidney Injury Molecule-1; Liver-type Fatty Acid-Binding Protein; Contrast

MeSH Terms

Acute Kidney Injury/blood/*chemically induced/*urine
Biological Markers/urine
Cardiac Catheterization/*adverse effects
Child
Contrast Media/adverse effects/diagnostic use
Fatty Acid-Binding Proteins/*urine
Female
Heart Defects, Congenital/complications/*radiography
Humans
Iohexol/adverse effects/*analogs & derivatives/diagnostic use
Male
Radiography, Interventional/adverse effects
Reproducibility of Results
Sensitivity and Specificity
Biological Markers
Contrast Media
Fatty Acid-Binding Proteins
Iohexol

Figure

• 

  Fig. 1 Change of urine KIM-1 at time after cardiac catheterization using contrast. KIM-1, kidney injury molecule-1. 0 vs. 48 hr, P = 0.017; 6 vs. 48 hr, P = 0.011.

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  Fig. 2 Change of urine L-FABP at time after cardiac catheterization using contrast. L-FABP, liver-type fatty acid-binding protein. 24 vs. 48 hr, P = 0.019.

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