Assessment of Plasma and NGAL for the Early Prediction of Acute Kidney Injury After Cardiac Surgery in Adults Study
Assessment of Plasma and NGAL for the Early Prediction of Acute Kidney Injury After Cardiac Surgery in Adults Study
The study aims to recruit 156 (54 Acute Kidney Injury (AKI);102 non-AKI) patients undergoing
 Cardio pulmonary bypass (CPB) surgery, including those with Chronic Kidney Disease (CKD) and
 multiple co-morbidities. Urine and blood samples collected pre-operatively and then 0, 3, 6
 and 18 hours post-CPB will be stored at -80oC until batch analysed for NGAL using the Abbott
 and BioPorto assays. AKI - defined as a ≥50% rise in serum creatinine (SCr) over baseline, or
 the requirement for renal replacement therapy (RRT). SCr will be measured pre-operatively
 (baseline), then 12 hourly for the first 48 hrs post-CPB and thereafter 24 hourly for 5 days.
 Clinical data collected will include patient demographics, co-morbidities, drug history,
 pre-operative renal function, surgery details (type, length, CPB time etc.), length of
 Intensive treatment unit and hospital stay and post-operative complications. Data will then
 be analysed comparing the two NGAL tests to find out which is superior, whether it is better
 to use blood or urine and to define optimal NGAL cut-offs and sample timing for predicting
 AKI. Both the Abbott and BioPorto assays will subject to a laboratory method evaluation prior
 to the analysis of any patient specimens in order to verify that their performance is
 acceptable and meets the manufacturer's claims. This will involve measuring the standard
 parameters used to assess laboratory assay performance e.g. imprecision (reproducibility),
 linearity, recovery and method comparison etc.
Inclusion Criteria:

 -  Adult patients undergoing cardiac surgery,

 -  Including patients with both normal renal function (eGFR >60 mL/min) and pre-operative
 CKD (eGFR < 60 mL/min),

 -  Include patients with other existing co-morbidity (e.g. diabetes, vascular disease,
 hypothyroidism) plus those with risk factors of AKI e.g. nephrotoxic drugs.

 Exclusion Criteria:

 -  Patients already on renal replacement therapy (RRT)

 -  Post-renal transplant patients

 -  Emergency surgery

 -  Patients <18 yrs of age

 -  Pregnancy

 -  Patients already involved with other on-going clinical studies