L-Carnitine, a new biomarker screened based on untargeted metabolomics, predicts cardiac surgery-associated acute kidney injury - a prospective cohort study

Sep 30, 2026

Uploaded by Kurz

This prospective cohort study evaluates the diagnostic potential of L-carnitine (LC) for early detection of cardiac surgery-associated acute kidney injury (CSA-AKI). Clinical data and serum samples were prospectively collected from 27 ICU patients at Nanjing Medical University Affiliated Nanjing Hospital (Feb–Mar 2024) and from cardiac surgery patients (May–Jul 2024). Untargeted metabolomics identified LC as a differential metabolite, and LC levels plus clinical markers were assessed with multivariate logistic regression and ROC analysis. Postoperative LC significantly predicted CSA-AKI and improved predictive performance when integrated into a clinical model.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

Clinical context and limitations of traditional markers

Rationale for metabolomics and novel biomarkers

Chen et al. BMC Nephrology (2026) 27:23 [https://doi.org/10.1186/s12882-025-04593-3](https://doi.org/10.1186/s12882-025-04593-3) BMC Nephrology RESEARCH Open Access L-Carnitine, a new biomarker screened based on untargeted metabolomics, predict cardiac surgery-associated acute kidney injury: a prospective cohort study Wenxiu Chen 1,2†, Hao Zhang3†, Xiao Shen2, Liang Hong2, Hong Tao 1, Ming Chen 1, Cui Zhang2*† and Wenkui Yu 1*† Abstract Background This study aims to evaluate the diagnostic potential of L-carnitine (LC) for the early detection of cardiac surgery-associated acute kidney injury (CSA-AKI) . Methods We collected clinical data and serum samples from 27 patients admitted to the Intensive Care Unit (ICU) of Nanjing Medical University Affiliated Nanjing Hospital between February 2024 and March 2024. Among these, 13 patients were diagnosed with CSA-AKI, while 14 served as non-AKI controls. Untargeted metabolomic analysis revealed LC as a differential ly expressed metabolite between the two groups. In addition, clinical data and serum samples were prospectively collected from patients undergoing cardiac surgery at Nanjing Medical University Affiliated Nanjing Hospital between May 2024 and July 2024. Serum samples were taken preoperatively (immediately upon entering the operating room) and postoperatively (immediately upon ICU admission) . The levels of blood urea nitrogen (BUN), serum creatinine (Scr), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and LC were measured. Multivariate logistic regression analysis was used to find independent risk variables for CSA-AKI. The predictive performance of the biomarkers, the clinical model, and their combination were evaluated using the area under the receiver operating characteristic curve (AUC) . Results This study included 170 patients who met the inclusion criteria for cardiac surgery. The incidence of CSA-AKI was 27 . 06%(46/170) . Multivariate logistic regression analysis indicated that preoperative heart failure, vasopressorinotropic score, and postoperative partial pressure of oxygen were independent risk factors for the development of CSA-AKI. Serum biomarker analysis showed significant differences in BUN, Scr, NGAL, and LC levels before and after cardiac surgery. After surgery, LC levels in patients with CSA-AKI were considerably lower than those in patients without CSA-AKI. Postoperative LC showed significant predictive value for CSA-AKI, with an AUC of 0.777 (95%CI: | †Wenxiu Chen and Hao Zhang contributed equally to this work. | | --- | | †Cui Zhang and Wenkui Yu contributed equally to this work. | *Correspondence: Cui Zhang [zhangcuiacc@163.com](zhangcuiacc@163.com)[ ](zhangcuiacc@163.com)Wenkui Yu[yudrnj2@163.com](yudrnj2@163.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Chen et al. BMC Nephrology (2026) 27:2

FAQs

What is the main aim of this study?

To evaluate the diagnostic potential of L-carnitine (LC) for early detection of cardiac surgery-associated acute kidney injury (CSA-AKI).

How were patients and samples collected in the study?

Clinical data and serum samples were collected from ICU patients (Feb–Mar 2024) and prospectively from patients undergoing cardiac surgery (May–Jul 2024), with samples taken preoperatively and postoperatively.

Which factors were found to be independent risk variables for CSA-AKI?

Preoperative heart failure, vasopressorinotropic score, and postoperative partial pressure of oxygen were identified as independent risk factors in multivariate logistic regression.

Sep 30, 2026

Uploaded by Kurz