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Kidney Week

Abstract: SA-PO0074

Transdermal Measurement Detects GFR Changes During Cardiopulmonary Bypass (CPB): A Preclinical Ovine Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Dorshow, Richard B., MediBeacon Inc, St. Louis, Missouri, United States
  • Mehdizadeh Shrifi, Amir, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Johnson, James R., MediBeacon Inc, St. Louis, Missouri, United States
  • Turner, Darren, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Ahmed, Hosam, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Abplanalp, William, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Morales, David Luis, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
Background

Acute kidney injury (AKI) is associated with poor outcomes in patients undergoing CPB. AKI diagnosis depends on changes in SCr and/or UOP measured post-operatively. Relmapirazin (MB-102) is a fluorescent GFR marker that is detectable transdermally; decreases in transdermal fluorescent intensity (TFI) can be translated in real-time to an accurate GFR (tGFR) in patients with stable kidney function. We leveraged continuous tGFR monitoring to assess for tGFR changes with renal perfusion in a CPB ovine model.

Methods

We assessed tGFR (ml/min) in two sheep. The tGFR sensor was attached and study sequence was: 1) injection before CPB (1 hour), during CPB (4 hours) and after CPB (1 hour) and 2) for 4 hours POD1 & POD2. TGFR was assessed at a low perfusion (40 ml/kg/min) and high rate (80 ml/kg/min) rates. tGFR changes relative to baseline pre-CPB values were averaged.

Results

Continuous TFI slopes change instantaneously with CPB flow changes (Figure 1). Individual tGFR values for each phase are shown in Table 1. tGFR nadirs from baseline with low CPB flow, increases with high CPB flow and again off CPB, but did not return to baseline by POD 2 (Figure 2).

Conclusion

Transdermal MB102 TFI changes reflect changes in renal perfusion on CPB and tGFR values differ with renal perfusion. We observed persistent decreases in tGFR on POD1 and POD2 compared to baseline. We suggest real-time transdermal GFR assessment is possible during and after CPB with our technology.

Transdermal GFR Values (ml/min)
SheepPre-CPBLow FlowHigh FlowOff CPBPOD 1POD 2
113131808178112
21961325537392

Figure 1

Figure 2

Funding

  • Commercial Support – MediBeacon, Incorporated

Digital Object Identifier (DOI)