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So what can we do?. Early Detection. 1,219 adult cardiac surgery patients AKI = need for RRT or 2-fold rise in creatinine Urine IL-18 and plasma NGAL peaked within 6 hours Highest quintiles of both had >5-fold odds of AKI Associated with more adverse outcomes – death, LOS
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So what can we do? Early Detection • 1,219 adult cardiac surgery patients • AKI = need for RRT or 2-fold rise in creatinine • Urine IL-18 and plasma NGAL peaked within 6 hours • Highest quintiles of both had >5-fold odds of AKI • Associated with more adverse outcomes – death, LOS • Addition of both improved ROC for AKI over clinical predictors alone Parikh CR, et al. J Am SocNephrol2011 Sep;22(9): 1748-57