Pediatric Nephrology

, Volume 23, Issue 6, pp 977–984 | Cite as

Metabonomics of acute kidney injury in children after cardiac surgery

  • Richard D. Beger
  • Ricky D. Holland
  • Jinchun Sun
  • Laura K. Schnackenberg
  • Page C. Moore
  • Catherine L. Dent
  • Prasad Devarajan
  • Didier Portilla
Original Article

Abstract

Acute kidney injury (AKI) is a major complication in children who undergo cardiopulmonary bypass surgery. We performed metabonomic analyses of urine samples obtained from 40 children that underwent cardiac surgery for correction of congenital cardiac defects. Serial urine samples were obtained from each patient prior to surgery and at 4 h and 12 h after surgery. AKI, defined as a 50% or greater rise in baseline level of serum creatinine, was noted in 21 children at 48–72 h after cardiac surgery. The principal component analysis of liquid chromatography/mass spectrometry (LC/MS) negative ionization data of the urine samples obtained 4 h and 12 h after surgery from patients who develop AKI clustered away from patients who did not develop AKI. The LC/MS peak with mass-to-charge ratio (m/z) 261.01 and retention time (tR) 4.92 min was further analyzed by tandem mass spectrometry (MS/MS) and identified as homovanillic acid sulfate (HVA-SO4), a dopamine metabolite. By MS single-reaction monitoring, the sensitivity was 0.90 and specificity was 0.95 for a cut-off value of 24 ng/μl for HVA-SO4 at 12 h after surgery. We concluded that urinary HVA-SO4 represents a novel, sensitive, and predictive early biomarker of AKI after pediatric cardiac surgery.

Keywords

Metabonomics Acute renal failure Acute kidney injury Biomarkers Homovanillic acid sulfate 

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Copyright information

© IPNA 2008

Authors and Affiliations

  • Richard D. Beger
    • 1
  • Ricky D. Holland
    • 1
  • Jinchun Sun
    • 1
  • Laura K. Schnackenberg
    • 1
  • Page C. Moore
    • 2
  • Catherine L. Dent
    • 3
  • Prasad Devarajan
    • 4
  • Didier Portilla
    • 5
  1. 1.Division of Systems ToxicologyUnited States Food and Drug Administration, National Center for Toxicological ResearchJeffersonUSA
  2. 2.Department of BiostatisticsUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.Cardiology, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati School of MedicineCincinnatiUSA
  4. 4.Nephrology & Hypertension, Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati School of MedicineCincinnatiUSA
  5. 5.Division of Nephrology, Department of Internal MedicineUniversity of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare SystemLittle RockUSA

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