- Poster presentation
- Open Access
Elevation of serum phosphorus, an early biomarker of acute kidney injury after cardiac sugery?
© Ridolfo et al.; 2015
- Published: 1 October 2015
- Positive Predictive Value
- Cardiopulmonary Bypass
- Renal Replacement Therapy
- Negative Predictive Value
- Acute Kidney Injury
Acute kidney injury (AKI) is common after cardiac surgery and is a strong predictor of morbidity and mortality . Hyperphosphatemia following AKI, by renal excretion defect, has never been studied in this context and could be a simple marker of AKI.
The aim of this study was to assess the predictability of serum phosphorus (Ph) for AKI monitoring after cardiac surgery.
In this retrospective diagnostic validation study of 547 patients admitted in our institute between January 2012 and December 2012, we excluded patients with end stage renal disease (clearance < 15mL / min / 1.73m2) or dialyzed, solitary kidney or nephrectomy, lack of data. Serum creatinine (Cr) and Ph were measured preoperatively and postoperatively specifically (H0, H12, H24, H48, H72). The percentage of maximum elevation of Ph (%EPh = [(maximum -minimum) / minimum] * 100) was calculated. AKI was defined as an increase Cr more than 26.5 mmol / L in 48 hours according to KDIGO criteria .The diagnostic performance of postoperative Ph thresholds were analysed by elaborating area under the receiver operating characteristic curves (AUC-ROC) with sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV).
60 ± 45
1.25 ± 0.4
74 ± 58
1.73 ± 0.4
159 ± 132
1.80 ± 0.5
AUC (IC95% )
After cardiac surgery, serum phosphorus seems to be a simple, reliable and inexpensive biomarker at bedside for AKI monitoring. A value less than 1.53 mmol/L at 48h may predict the no-initiation of RRT in case of AKI and may guide the clinician to a non-invasive-AKI therapeutic. Obviously, these results should be interpreted with caution regarding the retrospective nature of the study.
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