Acute kidney injury after using contrast during cardiac catheterization in children with heart disease

Area of Science:

• Pediatric Nephrology
• Cardiology
• Biomarker Discovery

Background:

• Acute kidney injury (AKI) is a significant risk factor for mortality and chronic kidney disease progression, particularly in pediatric patients.
• Cardiac catheterization in children with heart disease carries a risk of contrast-induced nephropathy.
• Early detection of subclinical AKI is crucial for timely intervention.

Purpose of the Study:

• To assess contrast-induced AKI in children with heart disease following cardiac catheterization.
• To evaluate the clinical utility of candidate biomarkers for AKI detection.
• To identify reliable markers for subclinical AKI in this vulnerable population.

Main Methods:

• Prospective study involving 26 children with heart disease undergoing cardiac catheterization.
• Collection of blood and urine samples at baseline (0 hr) and at 6, 24, and 48 hours post-procedure.
• Analysis of serum creatinine and urinary biomarkers including kidney injury molecule-1, IL-18, neutrophil gelatinase-associated lipocalin, and liver-type fatty acid-binding protein (L-FABP).

Main Results:

• No significant increase in serum creatinine levels was observed within 48 hours post-catheterization.
• Urinary L-FABP demonstrated a biphasic pattern with significant differences noted between 24 and 48 hours.
• Other tested urinary biomarkers (KIM-1, IL-18, NGAL) did not show similar distinct patterns.

Conclusions:

• Urinary L-FABP may serve as a valuable biomarker for detecting subclinical AKI induced by contrast media prior to cardiac procedures in children.
• L-FABP offers a potential advantage over traditional markers like serum creatinine for early AKI detection in this cohort.
• Further research is warranted to validate L-FABP's role in clinical practice for pediatric contrast-induced AKI.