Radovic, Mina (37075736200)Mina (37075736200)RadovicBojic, Suzana (55965837500)Suzana (55965837500)BojicKotur-Stevuljevic, Jelena (6506416348)Jelena (6506416348)Kotur-StevuljevicLezaic, Visnja (55904881900)Visnja (55904881900)LezaicMilicic, Biljana (6603829143)Biljana (6603829143)MilicicVelinovic, Milos (6507311576)Milos (6507311576)VelinovicKaran, Radmila (47161180600)Radmila (47161180600)KaranSimic-Ogrizovic, Sanja (55923197400)Sanja (55923197400)Simic-Ogrizovic2025-06-122025-06-122019https://doi.org/10.2478/jomb-2018-0018https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049165398&doi=10.2478%2fjomb-2018-0018&partnerID=40&md5=773539d604cba7d9dd65297afcd7b3b9https://remedy.med.bg.ac.rs/handle/123456789/5973Background Cardiac surgery-associated acute kidney injury (CSA-AKI) frequently occurs in patients assessed as low-risk for developing CSA-AKI. Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule-1 (KIM-1) and lactate are promising biomarkers of CSA-AKI but have not yet been explored in low-risk patients. Aim To evaluate urinary NGAL (uNGAL), KIM-1 and lactate as biomarkers of CSA-AKI in patients with low-risk for developing CSA-AKI. Methods This prospective, observational study included 100 adult elective cardiac surgery patients assessed as low-risk for developing CSA-AKI. UNGAL, KIM-1 and lactate were measured preoperatively, at the end of cardiopulmonary bypass (CPB) and 3, 12, 24 and 48 h later. Results Fifteen patients developed CSA-AKI. Patients with CSA-AKI had significantly higher lactate but similar uNGAL and KIM-1 levels compared to patients without CSA-AKI. Unlike uNGAL and KIM-1, postoperative lactate was good biomarker of CSA-AKI with the highest odds ratio (OR) 2.7 [1.4-4.9] 24 h after CPB. Peak lactate concentration ≥ 4 mmol/L carried dramatically higher risk for developing CSA-AKI (OR 6.3 [1.9-20.5]). Conclusions Unlike uNGAL and KIM-1, postoperative lactate was significant independent predictor of CSA-AKI with the highest odds ratio 24 h after CPB. © 2019 Mina Radovic, Suzana Bojic, Jelena Kotur-Stevuljevic, Visnja Lezaic, Biljana Milicic, Milos Velinovic, Radmila Karan, Sanja Simic-Ogrizovic, published by sciendo.acute kidney injurycardiac surgeryKidney Injury Molecule-1lactateNeutrophil Gelatinase-Asso - ciated Lipocalin