Predictive value of three detection indicators for acute kidney injury after cardiac surgery in infants and young children

FAN Chunling; GUO Wenzhi; LIU Yongzhe

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Medical Journal of the Chinese People Armed Police Forces ›› 2025, Vol. 36 ›› Issue (5) : 388-393.

Predictive value of three detection indicators for acute kidney injury after cardiac surgery in infants and young children

FAN Chunling¹, GUO Wenzhi², LIU Yongzhe³

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Abstract

Objective To explore the early diagnostic value of Dickkopf-associated protein 3（DKK3）tissue preparation of metalloproteinase 2 (TIMP-2), and human insulin-like growth factor binding protein 7 (IGFBP7) for acute kidney injury (AKI) in infants and young children after cardiopulmonary bypass (CPB) cardiac surgery. Methods A total of 50 children who underwent cardiac surgery at the Seventh Medical Center of PLA General Hospital from December 2020 to April 2022 were selected, and divided into the AKI group and the non-AKI group according to the criteria of the International Group for Improving Global Prognosis of Nephrology (KDIGO). The concentrations of DKK3 and [TIMP-2]•[IGFBP7] in the urine of the two groups before the operation, 3 hours after CPB, and 24 hours after CPB were compared. The diagnostic value of postoperative AKI was evaluated by using the receiver operating characteristic curve (ROC). Results Compared with the non-AKI group,the preoperative DKK3 levels and the levels of TIMP-2]•[IGFBP7] at 3 and 24h after CPB were significantly increased in the AKI group . Logistic regression analysis showed that the preoperative DKK3 （OR=26.32, 95%CI：1.75~396.30,P=0.018）,and[TIMP-2]•[IGFBP7] at 3h after CPB （OR=1.22, 95%CI：1.03~1.43,P=0.022） and 24h after CPB （OR=1.16, 95%CI：1.02~1.31,P=0.021） were independent risk factors for AKI after cardiac surgery. The ROC analysis further confirmed that the preoperative DKK3 （AUC=0.75）,[TIMP-2]•[IGFBP7]at 3h after CPB AUC=0.77） and 24h after CPB （AUC=0.75） had relatively high predictive value. Specific threshold analysis indicated that when preoperative DKK3 was less than 1.89 ng/ml and [TIMP-2] • [IGFBP7] was <0.32 (ng/ml) 2/1000 at 3 h and 24 h after CPB, the risk of AKI was significantly reduced. Conclusions Urinary DKK3 and TIMP-2]•[IGFBP7]serve as valuable biomarkers for the early detection of AKI after cardiac surgery in Chinese infants and young children.

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DKK3 / TIMP-2 / IGFBP7 / acute kidney injury / cardiopulmonary bypass / infants and young children

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FAN Chunling, GUO Wenzhi, LIU Yongzhe. Predictive value of three detection indicators for acute kidney injury after cardiac surgery in infants and young children[J]. Medical Journal of the Chinese People Armed Police Forces. 2025, 36(5): 388-393

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