Background Acute kidney injury (AKI) occurs in 42%–64% of the neonatal patients experiencing cardiac surgery, contributing to postoperative morbidity and mortality. Current diagnostic criteria, which are mainly based on serum creatinine and hourly urine output, are not sufficiently sensitive and precise to diagnose neonatal AKI promptly. The purpose of this review is to screen the recent literature, to summarize the novel and cost-effective biomarkers and approaches for neonatal AKI after cardiac surgery (CS-AKI), and to provide a possible research direction for future work. Data sources We searched PubMed for articles published before November 2019 with pertinent terms. Sixty-seven articles were found and screened. After excluding 48 records, 19 articles were enrolled for final analysis. Results Nineteen articles were enrolled, and 18 possible urinary biomarkers were identified and evaluated for their ability to diagnose CS-AKI. Urinary neutrophil gelatinase-associated lipocalin (uNGAL), serum cystatin C (sCys), urinary human kidney injury molecule-1 (uKIM-1), urinary liver fatty acid-binding protein (uL-FABP) and interleukin-18 (uIL-18) were the most frequently described as the early predictors of neonatal CS-AKI. Conclusions Neonates are vulnerable to CS-AKI. UNGAL, sCys, uL-FABP, uKIM-1 and uIL-18 are potential biomarkers for early prediction of neonatal CS-AKI. Renal regional oxygen saturation by near-infrared spectroscopy is a non-invasive approach for early identification of neonatal AKI. Further work should focus on exploring a sensitive and specific combined diagnostic model that includes novel biomarkers and other complementary methods.

中文翻译：

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心脏手术新生儿急性肾损伤的早期预测

背景 急性肾损伤 (AKI) 发生在 42%–64% 的接受心脏手术的新生儿患者中，导致术后发病率和死亡率。目前主要基于血清肌酐和每小时尿量的诊断标准不够灵敏和准确，无法及时诊断新生儿 AKI。本综述的目的是筛选近期文献，总结心脏手术后新生儿 AKI (CS-AKI) 的新型且具有成本效益的生物标志物和方法，并为未来的工作提供可能的研究方向。数据来源 我们在 PubMed 中搜索了 2019 年 11 月之前发表的带有相关术语的文章。找到并筛选了 67 篇文章。排除 48 条记录后，最终纳入 19 篇文章进行分析。结果 19 篇文章被纳入，确定了 18 种可能的尿液生物标志物，并评估了它们诊断 CS-AKI 的能力。尿液中性粒细胞明胶酶相关脂质运载蛋白 (uNGAL)、血清胱抑素 C (sCys)、尿液人肾损伤分子-1 (uKIM-1)、尿液肝脂肪酸结合蛋白 (uL-FABP) 和白细胞介素 18 (uIL-18) ) 是最常被描述为新生儿 CS-AKI 的早期预测因子。结论 新生儿易患 CS-AKI。UNGAL、sCys、uL-FABP、uKIM-1 和 uIL-18 是早期预测新生儿 CS-AKI 的潜在生物标志物。近红外光谱法检测肾脏局部血氧饱和度是一种早期识别新生儿 AKI 的非侵入性方法。进一步的工作应侧重于探索一种敏感和特异的联合诊断模型，其中包括新的生物标志物和其他补充方法。