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Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery.
- Source :
-
Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2013 Jul; Vol. 8 (7), pp. 1079-88. Date of Electronic Publication: 2013 Apr 18. - Publication Year :
- 2013
-
Abstract
- Background and Objectives: AKI is common and novel biomarkers may help provide earlier diagnosis and prognosis of AKI in the postoperative period.<br />Design, Setting, Participants, & Measurements: This was a prospective, multicenter cohort study involving 1219 adults and 311 children consecutively enrolled at eight academic medical centers. Performance of two urine biomarkers, kidney injury molecule-1 (KIM-1) and liver fatty acid-binding protein (L-FABP), alone or in combination with other injury biomarkers during the perioperative period was evaluated. AKI was defined as doubling of serum creatinine or need for acute dialysis.<br />Results: KIM-1 peaked 2 days after surgery in adults and 1 day after surgery in children, whereas L-FABP peaked within 6 hours after surgery in both age groups. In multivariable analyses, the highest quintile of the first postoperative KIM-1 level was associated with AKI compared with the lowest quintile in adults, whereas the first postoperative L-FABP was not associated with AKI. Both KIM-1 and L-FABP were not significantly associated with AKI in adults or children after adjusting for other kidney injury biomarkers (neutrophil gelatinase-associated lipocalin and IL-18). The highest area under the curves achievable for discrimination for AKI were 0.78 in adults using urine KIM-1 from 6 to 12 hours, urine IL-18 from day 2, and plasma neutrophil gelatinase-associated lipocalin from day 2 and 0.78 in children using urine IL-18 from 0 to 6 hours and urine L-FABP from day 2.<br />Conclusions: Postoperative elevations of KIM-1 associate with AKI and adverse outcmes in adults but were not independent of other AKI biomarkers. A panel of multiple biomarkers provided moderate discrimination for AKI.
- Subjects :
- Academic Medical Centers
Acute Kidney Injury diagnosis
Acute Kidney Injury urine
Acute-Phase Proteins urine
Aged
Area Under Curve
Biomarkers urine
Child, Preschool
Early Diagnosis
Female
Hepatitis A Virus Cellular Receptor 1
Humans
Infant
Interleukin-18 urine
Linear Models
Lipocalin-2
Lipocalins urine
Logistic Models
Male
Middle Aged
North America
Predictive Value of Tests
Prognosis
Prospective Studies
Proto-Oncogene Proteins urine
ROC Curve
Receptors, Virus
Risk Factors
Acute Kidney Injury etiology
Cardiac Surgical Procedures adverse effects
Fatty Acid-Binding Proteins urine
Membrane Glycoproteins urine
Subjects
Details
- Language :
- English
- ISSN :
- 1555-905X
- Volume :
- 8
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Clinical journal of the American Society of Nephrology : CJASN
- Publication Type :
- Academic Journal
- Accession number :
- 23599408
- Full Text :
- https://doi.org/10.2215/CJN.10971012