Cystatin C And Neutrophil Gelatinase-associated Lipocalin Predict Postoperative Acute Kidney Injury In Children With Congenital Heart Disease

Objective:1.To exploer the Correlation between the serum Cystatin C (Cys C) andneutrophil gelatinase-associated lipocalin (NGAL) in patients with acute Kidney injury.2.To assess the prognostic value of Cys C and NGAL elevation in Patients with AKI.Method:80patients electived repair of congenital heart disease were enrolled in the study.At preoperative, postoperative and postoperative24-hour detected the level of serumcreatinine, Cys C and NGAL. The patients were followed up to hospital discharge,recorded perioperative data, including gender, age, residence time, operative time,cardiopulmonary bypass time, intraoperative urine output, intensive care unit time, tubestime and postoperative hospital stay. Acute kidney injury defined according to the revisedpediatric RIFLE classification. Results:(1) no patients according to the revised pediatricRIFLE criteria based on the development of acute kidney injury. Postoperative level ofserum Cys C higher than the preoperative, but did not reach the threshold that can predictacute kidney injury; the postoperative serum NGAL lower than the preoperative, showingthat serum Cys C and NGAL predict acute kidney injury effectively;(2)The severer thepulmonary hypertension, the higher the level of serum Cys C, and the postoperative serumCys C levels close to the threshold predict acute kidney injury in severe pulmonaryhypertension group.(3) Serum NGAL was positively correlated with Serum Cys C, butserum creatinine were not correlated with NGAL and Cys C.(4)The level of serum NGAL,Cys C were positively correlated with ICU retention time, but not correlated with theextubation time and postoperative hospitalization time. Conclusion: Elevated Cys C andNGAL levels had not only a predictive valuation for congenital heart disease patients withAKI prognosis, but also an additive effect on outcome prediction. The higher the risk of postoperative acute kidney injury with the deepening of the severity of pulmonaryhypertension in children with congenital heart disease with pulmonary hypertension.