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Examining New Diagnostic Tests for Acute Kidney Injury After Heart Surgery

This study has been completed.
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Chirag Parikh, Yale University Identifier:
First received: October 16, 2008
Last updated: February 2, 2015
Last verified: February 2015
People who undergo coronary artery bypass grafting (CABG) or heart valve surgery may experience acute kidney injury (AKI) after their surgery. Current medical tests cannot identify AKI until approximately 48 hours after it occurs. This study will examine three new biomarkers in blood and urine that may provide a more effective and faster way of predicting AKI in people who undergo CABG or heart valve surgery.

Kidney Failure, Acute Renal Insufficiency

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Phase IV Multi Center Validation Study of Novel Biomarkers of Acute Kidney Injury After Cardiac Surgery

Further study details as provided by Chirag Parikh, Yale University:

Primary Outcome Measures:
  • Changes in serum creatinine levels (absolute and percentage) [ Time Frame: Measured in the 1 week after surgery ]

Secondary Outcome Measures:
  • Doubling of serum creatinine, use of dialysis, or death [ Time Frame: Measured during hospitalization ]

Biospecimen Retention:   Samples With DNA
Urine, plasma, buffy coat (optional)

Enrollment: 1550
Study Start Date: April 2007
Study Completion Date: February 2014
Primary Completion Date: February 2013 (Final data collection date for primary outcome measure)
Detailed Description:

AKI, which is indicated by a sudden change in serum creatinine levels, is a serious complication that can occur after a patient undergoes CABG or heart valve surgery. People who experience AKI after heart surgery may be at increased risk for post-operative complications, including long-term kidney failure or heart damage. AKI is currently identified by testing serum creatinine levels in the blood, which is the traditional marker of kidney function. However, serum creatinine levels can be affected by other non-kidney-related factors and may not positively identify AKI until 48 hours after it begins. This study will examine three new biomarkers found in urine and blood—urine interleukin 18 (IL-18), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin C—that may be able to predict AKI more effectively and faster than serum creatinine levels. In addition, study researchers will also determine if changes in these biomarkers can predict the severity of AKI more successfully than serum creatinine tests.

This study will enroll people undergoing CABG or heart valve surgery at Yale-New Haven Hospital. Before the surgery and once a day for 5 days after the surgery, blood and urine collection will occur. Study researchers will also review participants' medical records. Twelve months after hospital discharge, participants will return to the clinic for a follow-up visit for repeat blood and urine collection and to complete questionnaires. A portion of blood will be saved for future genetic testing; this is optional.


Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
  1. Adults undergoing CABG surgery or heart valve surgery.
  2. Children undergoing cardic surgery (requiring CABG) to correct congenital heart defects.

Inclusion Criteria for Adults: (must have at least one of the following)

  • Emergent surgery
  • Pre-existing kidney impairment (baseline serum creatinine greater than 2 mg/dL)
  • Ejection fraction less than 35%
  • At least 70 years old
  • Diabetes mellitus
  • Combined CABG and valve surgery
  • Repeat CABG or valve surgery

Exclusion Criteria for Adults:

  • Pre-operative acute kidney injury
  • Enrolled in a conflicting research study
  • Prior kidney transplantation
  • Baseline serum creatinine level greater than 4.5 mg/dL
  • Nephrotoxic drugs administered pre-operatively
  • Surgery for only left ventricular assist device

Inclusion Criteria for Children:

  • Undergoing open heart surgery

Exclusion Criteria for Children:

  • Pre-existing acute kidney failure (greater than 50% decline in creatinine clearance)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00774137

United States, Colorado
University of Colorado Health Sciences Center
Denver, Colorado, United States, 80262
United States, Connecticut
Danbury Hospital
Danbury, Connecticut, United States, 06810
Yale University School of Medicine
New Haven, Connecticut, United States, 06510
United States, Illinois
University of Chicago School of Medicine
Chicago, Illinois, United States, 60637
United States, North Carolina
Duke Clinical Research Institute
Durham, North Carolina, United States, 27705
United States, Ohio
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States, 45229
Canada, Ontario
London Health Sciences Centre
London, Ontario, Canada, N6A 4G5
Canada, Quebec
Montreal Children's Hospital at McGill University Health Centre
Montreal, Quebec, Canada, H3H 1P3
Sponsors and Collaborators
Yale University
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Chirag R. Parikh, MD, PhD Yale University
  More Information

Additional Information:
Yale  This link exits the site


Publications automatically indexed to this study by Identifier (NCT Number):

Responsible Party: Chirag Parikh, Associate Professor, Yale University Identifier: NCT00774137     History of Changes
Other Study ID Numbers: 588
R01HL085757 ( U.S. NIH Grant/Contract )
Study First Received: October 16, 2008
Last Updated: February 2, 2015

Keywords provided by Chirag Parikh, Yale University:
Acute Kidney Injury
Cystatin C

Additional relevant MeSH terms:
Acute Kidney Injury
Renal Insufficiency
Kidney Diseases
Urologic Diseases processed this record on September 21, 2017