C-C motif chemokine ligand 14 characterization for prediction of persistent severe AKI in post-cardiac surgery children

Katie Brandewie; Jeffrey A Alten; Stuart L Goldstein; James Rose; Michael E Kim; Nicholas J Ollberding; Huaiyu Zang; Katja M Gist

doi:10.1007/s00467-024-06592-2

C-C motif chemokine ligand 14 characterization for prediction of persistent severe AKI in post-cardiac surgery children

Pediatr Nephrol. 2024 Nov 18. doi: 10.1007/s00467-024-06592-2. Online ahead of print.

Authors

Katie Brandewie¹, Jeffrey A Alten², Stuart L Goldstein³, James Rose², Michael E Kim⁴, Nicholas J Ollberding⁵, Huaiyu Zang⁵, Katja M Gist²

Affiliations

¹ Division of Pediatric Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. katie.brandewie@bcm.edu.
² Division of Pediatric Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ Division of Nephrology and Hypertension, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁴ Divison of Critical Care Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
⁵ Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

PMID: 39557702
DOI: 10.1007/s00467-024-06592-2

Abstract

Background: We evaluate the association of early postoperative urinary c-c motif chemokine ligand 14 (CCL14) and persistent severe acute kidney injury (AKI) in pediatric post-cardiac surgery patients.

Methods: This is a retrospective single-center cohort study of patients < 18 years of age undergoing cardiac surgery who provided a biorepository urine sample within the first 24 postoperative hours. Persistent severe AKI was defined as any AKI stage lasting for ≥ 72 h with at least one time point of AKI stage 2 or 3 during that time frame. Patients with persistent severe AKI were matched 2:1 with non-AKI patients on age and sex. Urine samples were measured for CCL14 concentration. Logistic regression was used to evaluate associations between CCL14 and persistent severe AKI.

Results: Persistent severe AKI occurred in 14 (5.4%) patients and was more common in patients with higher surgical complexity and longer cardiopulmonary bypass and cross-clamp duration. Patients with persistent severe AKI had longer median cardiac intensive care unit (CICU) (5 [3, 10] vs. 2 [1.5, 5.5], p-value = 0.039) and hospital length of stays (13.5 [7.8, 16.8] vs. 6 [4,8], p-value = 0.009). There was no difference in CCL14 levels between patients with and without persistent severe AKI (46.7 pg/ml [31.0, 82.9] vs. 44.2 pg/ml [25.1, 74.9], p-value = 0.49) in univariable and logistic regression.

Conclusions: In this heterogenous cohort of children undergoing cardiac surgery, CCL14 was not associated with persistent severe AKI. Future studies are needed to evaluate the use of CCL14 for predicting persistent severe AKI in children.

Keywords: Acute kidney injury; Biomarker; CCL14; Cardiac surgery; Pediatric.