الفهرس 
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Abstract
This study was conducted as a descriptive cross-sectional study to evaluate the clinical effectiveness of lipocalin levels as an early biomarker in prediction of acute kidney injury after cardiopulmonary bypass surgery. This study was undertaken at Pediatric Cardio Surgery Academy, Ain Shams University Hospital. This study involved 30 patients, 63.3 % were males and 36.66% were females. The mean age was 43 months and ranged from 0.25 to 204 months.
Urine and blood samples were collected simultaneously for each patient at predetermined time points: base line: before CPB surgery; 2 hours after CPB; 24 hours after CPB; 48 hours after CPB.
Urinary lipocalin2, SCr and b.urea were measured at these time points. SCr concentrations, in mg/dl and b.urea concentrations, in mg/dl were measured in the immediate preoperative period (baseline SCr) and at 2 hours postoperative and then at day 1 and day 2 after CPB. Urine lipocalin measurements were expressed as ng/ml, were measured in the immediate preoperative period (baseline lipocalin) and at 2 hours postoperative and then at day 1 after CPB surgery. According these tests we classified the children into AKI group and non-AKI group. About 30 % of our study population developed AKI after CPB surgery.
Both of SCr and b.urea were found to be higher in AKI group, but they didn’t show a significant increase until day 2 after CPB surgery, while urinary lipocalin showed significant increase in AKI children immediately after CPB surgery. Urine lipocalin was more accurate diagnostic test than SCr for diagnosis of kidney injury.
Using the AUC ROC analysis, representing the diagnostic value of
urine lipocalin to predict AKI after cardiac surgery, An AUROC of 1.0 was taken to indicate excellent predictive ability at 2 hours after CPB surgery. Urine lipocalin2 was more sensitive (100%) and more specific (100%) for diagnosis of acute kidney injury than SCr (55.6% , 81%).
Correlation analyses were performed to examine the relationship of urine lipocalin2 concentrations with clinical characteristics and outcomes. At base line, no significant correlations were found between urine lipocalin2 concentrations and any variable. Urine lipocalin2 concentrations at 2 hours significantly correlated with greater SCr concentration change at 48 hours post-surgery, longer hospital stay, longer CPB time and longer duration of surgery. Furthermore, Urine lipocalin2 concentrations at 2 hours had moderate significant correlations with cyanotic heart disease and deaths. These same significant relationships were maintained at all points through 48 hours, with both SCr and urine lipocalin.