Urinary biomarkers predict advanced acute kidney injury after cardiovascular surgery

Acute kidney injury (AKI) after cardiovascular surgery is a serious complication. Little is known about the ability of novel biomarkers in combination with clinical risk scores for prediction of advanced AKI. In this prospectively conducted multicenter study, urine samples were collected from 149 ad...

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Published in:Critical care (London, England) England), 2018-04, Vol.22 (1), p.108-108, Article 108
Main Authors: Wang, Jian-Jhong, Chi, Nai-Hsin, Huang, Tao-Min, Connolly, Rory, Chen, Liang Wen, Chueh, Shih-Chieh Jeff, Kan, Wei-Chih, Lai, Chih-Cheng, Wu, Vin-Cent, Fang, Ji-Tseng, Chu, Tzong-Shinn, Wu, Kwan-Dun
Format: Article
Language:English
Subjects:
Acute kidney failure
Acute kidney injury
Biological markers
Biomarkers
Cardiovascular surgery
Complications and side effects
Hemojuvelin
Kidney injury molecule-1
Neutrophil gelatinase-associated lipocalin
Patient outcomes
Risk factors
α-Glutathione S-transferase
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Summary:Acute kidney injury (AKI) after cardiovascular surgery is a serious complication. Little is known about the ability of novel biomarkers in combination with clinical risk scores for prediction of advanced AKI. In this prospectively conducted multicenter study, urine samples were collected from 149 adults at 0, 3, 6, 12 and 24 h after cardiovascular surgery. We measured urinary hemojuvelin (uHJV), kidney injury molecule-1 (uKIM-1), neutrophil gelatinase-associated lipocalin (uNGAL), α-glutathione S-transferase (uα-GST) and π-glutathione S-transferase (uπ-GST). The primary outcome was advanced AKI, under the definition of Kidney Disease: Improving Global Outcomes (KDIGO) stage 2, 3 and composite outcomes were KDIGO stage 2, 3 or 90-day mortality after hospital discharge. Patients with advanced AKI had significantly higher levels of uHJV and uKIM-1 at 3, 6 and 12 h after surgery. When normalized by urinary creatinine level, uKIM-1 in combination with uHJV at 3 h post-surgery had a high predictive ability for advanced AKI and composite outcome (AUC = 0.898 and 0.905, respectively). The combination of this biomarker panel (normalized uKIM-1, uHJV at 3 h post-operation) and Liano's score was superior in predicting advanced AKI (AUC = 0.931, category-free net reclassification improvement of 1.149, and p 
ISSN:1364-8535
1466-609X
1364-8535
DOI:10.1186/s13054-018-2035-8