Informacja

Drogi użytkowniku, aplikacja do prawidłowego działania wymaga obsługi JavaScript. Proszę włącz obsługę JavaScript w Twojej przeglądarce.

Tytuł pozycji:

Outcome Prediction of Acute Kidney Injury Biomarkers at Initiation of Dialysis in Critical Units

Tytuł:
Outcome Prediction of Acute Kidney Injury Biomarkers at Initiation of Dialysis in Critical Units
Autorzy:
Vin-Cent Wu
Chih-Chung Shiao
Nai-Hsin Chi
Chih-Hsien Wang
Shih-Chieh Jeff Chueh
Hung-Hsiang Liou
Herbert D. Spapen
Patrick M. Honore
Tzong-Shinn Chu
Temat:
acute kidney injury
biomarker
fibroblast growth factor-23
kidney injury molecule-1
mortality
neutrophil gelatinase-associated lipocalin
renal replacement therapy
Medicine
Źródło:
Journal of Clinical Medicine, Vol 7, Iss 8, p 202 (2018)
Wydawca:
MDPI AG, 2018.
Rok publikacji:
2018
Kolekcja:
LCC:Medicine
Typ dokumentu:
article
Opis pliku:
electronic resource
Język:
English
ISSN:
2077-0383
Relacje:
http://www.mdpi.com/2077-0383/7/8/202; https://doaj.org/toc/2077-0383
DOI:
10.3390/jcm7080202
Dostęp URL:
https://doaj.org/article/3546681ef5084aa99aa8b1e1813cef5b  Link otwiera się w nowym oknie
Numer akcesji:
edsdoj.3546681ef5084aa99aa8b1e1813cef5b
Czasopismo naukowe
The ideal circumstances for whether and when to start RRT remain unclear. The outcome predictive ability of acute kidney injury (AKI) biomarkers measuring at dialysis initializing need more validation. This prospective, multi-center observational cohort study enrolled 257 patients with AKI undergoing renal replacement therapy (RRT) shortly after admission. At the start of RRT, blood and urine samples were collected for relevant biomarker measurement. RRT dependence and all-cause mortality were recorded up to 90 days after discharge. Areas under the receiver operator characteristic (AUROC) curves and a multivariate generalized additive model were applied to predict outcomes. One hundred and thirty-five (52.5%) patients died within 90 days of hospital discharge. Plasma c-terminal FGF-23 (cFGF-23) had the best discriminative ability (AUROC, 0.687) as compared with intact FGF-23 (iFGF-23) (AUROC, 0.504), creatinine-adjusted urine neutrophil gelatinase-associated lipocalin (AUROC, 0.599), and adjusted urine cFGF-23 (AUROC, 0.653) regardless whether patients were alive or not on day 90. Plasma cFGF-23 levels above 2050 RU/mL were independently associated with higher 90-day mortality (HR 1.76, p = 0.020). Higher cFGF-23 levels predicted less weaning from dialysis in survivors (HR, 0.62, p = 0.032), taking mortality as a competing risk. Adding cFGF-23 measurement to the AKI risk predicting score significantly improved risk stratification and 90-day mortality prediction (total net reclassification improvement = 0.148; p = 0.002). In patients with AKI who required RRT, increased plasma cFGF-23 levels correlated with higher 90-day overall mortality after discharge and predicted worse kidney recovery in survivors. When coupled to the AKI risk predicting score, cFGF-23 significantly improved mortality risk prediction. This observation adds evidence that cFGF-23 could be used as an optimal timing biomarker to initiate RRT.
Zaloguj się, aby uzyskać dostęp do pełnego tekstu.

Ta witryna wykorzystuje pliki cookies do przechowywania informacji na Twoim komputerze. Pliki cookies stosujemy w celu świadczenia usług na najwyższym poziomie, w tym w sposób dostosowany do indywidualnych potrzeb. Korzystanie z witryny bez zmiany ustawień dotyczących cookies oznacza, że będą one zamieszczane w Twoim komputerze. W każdym momencie możesz dokonać zmiany ustawień dotyczących cookies