Systematic review on: Prevention of Acute Renal Injury Following Cardiac Surgery In Children Using Neutrophil Gelatinase-Associated Lipocalin (NGAL) As an Early Diagnostic Biomarker. 2016

Abstract

Abstract: Introduction: Cardiopulmonary bypass (CPB) surgery is considered one of the most frequent surgical procedures in which acute kidney injury (AKI) represent a frequent and serious complication. The diagnosis of (AKI) depends on serum creatinine, which is a delayed and unreliable indicator of AKI. The aim of this review was to evaluate the effectiveness of neutrophil gelatinase associated lipocalin (NGAL) as an early AKI biomarker after CPB in pediatric cardiac surgery. Data sources: A systemic review of English articles using MEDLINE and PubMed websites selecting only prospective cohort studies. Search terms included, urinary NGAL, early diagnosis, acute renal injury, pediatrics undergoing cardiac surgery, renal biomarkers. This search was run in the period from February to June 2015. The search revealed 59 articles that appear to meet the eligibility criteria based on the title and abstract screen. Study selection: Only 6 prospective cohort studies studying the accuracy of urinary Neutrophil Gelatinase Associated lipocalin factor (uNGAL) for the early prediction of acute kidney injury (AKI) in pediatrics following cardiac surgery, were the only type of studies included in this review. Data extraction: Data extraction sheet was developed and refined based on Cochrane Consumers and Communication Review Groups data extraction template. Results: In all included studies (6 studies): uNGAL concentration had started to rise at the earliest time-point (as early as 2 hours after CPB) before SrCr in all patients who developed AKI .On the other hand peak SrCr levels are not evident until 24-72 hrs., following CPB.

Conclusion: Urine NGAL is a strong early predictive biomarker of AKI severity after cardiopulmonary bypass in pediatrics population