Related Experiment Video
Updated: Sep 15, 2025

Bilateral Renal Ischemia-Reperfusion Model for Acute Kidney Injury in Mice
Published on: February 2, 2024
Identifying kidney injury via urinary biomarkers after the comprehensive stage II palliation and bidirectional Glenn
Rachel Harris1,2,3, Tyler Cunningham1,2,4, Andrew R Yates1,5,2,6
1Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA.
Abstract:
Single ventricle patients undergoing comprehensive stage II palliation have higher incidence of severe acute kidney injury compared to the bidirectional Glenn palliation; however, the optimal method for early detection remains unknown. Several urinary biomarkers are increased in other patient populations with postoperative kidney injury. We explored the kinetics of these biomarkers in this high-risk population.We conducted prospective, observational study of 20 patients with single ventricle physiology who underwent second stage palliation (July 2019-December 2021). Acute kidney injury was defined by Kidney Diseases Improving Global Guidelines, based on peak serum creatinine value and urine output. Urine samples were collected pre-operatively and at 1-, 6-, and 24-hours post-surgery. Urinary biomarkers neutrophil gelatinase-associated lipocalin, interleukin-18, liver fatty acid-binding protein, kidney injury molecule-1, and cystatin C were quantified by enzyme linked immunosorbent assay, normalised to urinary creatinine, and shown as median [interquartile range].Four patients (50%) undergoing comprehensive stage II and 1 patient (8%) undergoing bidirectional Glenn palliation developed stage ≥ 2 acute kidney injury. Comprehensive stage II compared to bidirectional Glenn group had higher median neutrophil gelatinase-associated lipocalin (1769 [1309-1961] versus 91[18-1120] ng/mg) and liver fatty acid-binding protein (12,836 [5016-19798] versus 1272 [220-5172] ng/mg) that peaked 1-hour post-surgery. Kidney injury molecule-1 was significantly greater at 1-, 6-, and 24-hours (greatest) post-surgery in comprehensive stage II than bidirectional Glenn (24h: 11[9-23]) versus 2 [1-6] ng/mg).Elevated urinary neutrophil gelatinase-associated lipocalin, liver fatty acid-binding protein, and kidney injury molecule-1 may be useful biomarkers for early detection of acute kidney injury in children following comprehensive stage II palliation.
Related Concept Videos
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Acute Kidney Injury III: Clinical Manifestations
Chronic Kidney Disease III: Interprofessional Care
Kidney Transplant II: Surgical Procedure
Acute Kidney Injury II: Pathophysiology
Acute Kidney Injury I: Introduction

