Prediction of major adverse kidney events in critically ill burn patients

• Published in: Burns 2018-12, Vol.44 (8), p.1887-1894
• Main Authors: Dépret, François, Boutin, Louis, Jarkovský, Jiří, Chaussard, Maité, Soussi, Sabri, Bataille, Aurélien, Oueslati, Haikel, Moreno, Nabila, de Tymowski, Christian, Parenica, Jiří, Benešová, Klára, Vauchel, Thomas, Ferry, Axelle, Benyamina, Mourad, Cupaciu, Alexandru, Coutrot, Maxime, Garnier, Jean-Pierre, Serror, Kevin, Chaouat, Marc, Mebazaa, Alexandre, Legrand, Matthieu
• Format: Article
• Language: English
• Subjects: Acute kidney injury; Acute Kidney Injury - blood; Acute Kidney Injury - epidemiology; Acute Kidney Injury - metabolism; Adult; Aged; Burn patients; Burns - blood; Burns - metabolism; Burns - mortality; Cohort Studies; Creatinine - metabolism; Critical Illness; Female; Humans; Intensive Care Units; Lipocalin-2 - blood; Major adverse kidney event; Male; Middle Aged; Mortality; Plasmatic Neutrophil Gelatinase-Associated Lipocain; Prognosis; Prospective Studies; Recovery of Function; Renal Replacement Therapy - statistics & numerical data; Risk Assessment
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2018.08.007

•pNGAL at admission is a good predictor of severe AKI.•The biomarker is strongly associated with the risk of MAKE in this population.•pNGAL when added to clinical severity score, outperforms severity scores alone. We aimed at assessing the predictive value of plasmatic Neutrophil Gelatinase Associated Lipocalin (pNGAL) at admission and severity scores to predict major adverse kidney events (MAKE, defined as death and/or need for renal replacement therapy (RRT) and/or non-renal recovery at day 90) in critically ill burn patients. Single-center cohort study in a burn critical care unit in a tertiary center, including all consecutive severely burn patients (total burned body surface >20%) from January 2012 until January 2015 with a pNGAL dosage at admission. Reclassification of patients was assessed by Integrated Discrimination Improvement (IDI). 87 patients were included. Mean age was 47.7 (IQ 25–75: 33.4–65.2) years; total burn body surface area was 40 (IQ 25–75: 30–55) % and ICU mortality 36%. 39 (44.8%) patients presented a MAKE, 32 (88.9%) patients died at day 90. pNGAL was higher in the MAKE group (423 [IQ 25–75: 327–518]pg/mL vs 184 [IQ 25–75: 147–220]pg/mL, p