{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:52:45Z","timestamp":1783947165607,"version":"3.55.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019628","name":"BioPorto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019628","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Cardiac surgery associated acute kidney injury (CS-AKI) is common. Urine response to loop diuretic and urine neutrophil gelatinase associated lipocalin (uNGAL) are separately associated with CS-AKI. We aimed to determine whether urine response to loop diuretic <jats:italic>and<\/jats:italic> uNGAL together were associated with postoperative day 2\u20134 CS-AKI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Two-center prospective observational study (ages 0\u201318\u00a0years). uNGAL (8\u201312\u00a0h after admission) (ng\/mL) and urine response to loop diuretic (6\u00a0h for bolus furosemide and 12\u00a0h for infusion bumetanide) (mL\/kg\/hr) were measured. All diuretic doses were converted to furosemide equivalents. The primary outcome was day 2\u20134 CS-AKI. Patients were sub-phenotyped using a priori cutoffs (uNGAL\u2009+\u2009\u2009\u2265\u2009100\u00a0ng\/mL and UOP\u2009+\u2009\u2009&lt;\u20091.5\u00a0mL\/kg\/hr) and optimal cutoffs (uNGAL\u2009+\u2009\u2009\u2265\u2009127\u00a0ng\/mL and UOP\u2009+\u2009\u2009\u2264\u20090.79\u00a0mL\/kg\/hr): 1) uNGAL\u2013\/UOP\u2013, 2) uNGAL\u2013\/UOP\u2009+\u2009, 3) uNGAL\u2009+\u2009\/UOP\u2013, and 4) uNGAL\u2009+\u2009\/UOP\u2009+\u2009. Multivariable regression was used to assess the association of uNGAL, UOP and each sub-phenotype with outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>476 patients were included. CS-AKI occurred in 52 (10.9%). uNGAL was associated with 2.59-fold greater odds (95%CI: 1.52\u20134.41) of CS-AKI. UOP was not associated with CS-AKI. Compared with uNGAL\u2009+\u2009alone, uNGAL\u2009+\u2009\/UOP\u2009+\u2009improved prediction of CS-AKI using a priori and optimal cutoffs respectively (AUC 0.70 vs. 0.75). Both uNGAL\u2009+\u2009\/UOP\u2009+\u2009(IQR OR:4.63, 95%CI: 1.74\u201312.32) and uNGAL\u2009+\u2009\/UOP\u2013 (IQR OR:5.94, 95%CI: 2.09\u201316.84) were associated with CS-AKI when compared with uNGAL\u2013\/UOP\u2013.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>uNGAL is associated with CS-AKI. The sub-phenotype association was largely driven by uNGAL. Future studies standardizing diuretic dose and timing may be needed to refine the combined performance for clinical decision making.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00467-024-06469-4","type":"journal-article","created":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T14:02:52Z","timestamp":1723212172000},"page":"3597-3606","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prediction of cardiac surgery associated acute kidney injury using response to loop diuretic and urine neutrophil gelatinase associated lipocalin"],"prefix":"10.1007","volume":"39","author":[{"given":"Emily","family":"Sullivan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Melink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Pettit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart L.","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiayu","family":"Zang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Ollberding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"SooHoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Alten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalja L.","family":"Stanski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7427-670X","authenticated-orcid":false,"given":"Katja M.","family":"Gist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"6469_CR1","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1177\/039139880803100210","volume":"31","author":"R Bellomo","year":"2008","unstructured":"Bellomo R, Auriemma S, Fabbri A, D\u2019Onofrio A, Katz N, McCullough PA, Ricci Z, Shaw A, Ronco C (2008) The pathophysiology of cardiac surgery-associated acute kidney injury (CSA-AKI). 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