Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 225.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 259.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 259.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 259.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 259.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27538426
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+J+Am+Soc+Nephrol
2016 ; 11
(9
): 1536-1544
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Urinary Biomarkers at the Time of AKI Diagnosis as Predictors of Progression of
AKI among Patients with Acute Cardiorenal Syndrome
#MMPMID27538426
Chen C
; Yang X
; Lei Y
; Zha Y
; Liu H
; Ma C
; Tian J
; Chen P
; Yang T
; Hou FF
Clin J Am Soc Nephrol
2016[Sep]; 11
(9
): 1536-1544
PMID27538426
show ga
BACKGROUND AND OBJECTIVES: A major challenge in early treatment of acute
cardiorenal syndrome (CRS) is the lack of predictors for progression of AKI. We
aim to investigate the utility of urinary angiotensinogen and other renal injury
biomarkers in predicting AKI progression in CRS. DESIGN, SETTINGS, PARTICIPANTS,
& MEASUREMENTS: In this prospective, multicenter study, we screened 732 adults
who admitted for acute decompensated heart failure from September 2011 to
December 2014, and evaluated whether renal injury biomarkers measured at time of
AKI diagnosis can predict worsening of AKI. In 213 patients who developed Kidney
Disease Improving Global Outcomes stage 1 or 2 AKI, six renal injury biomarkers,
including urinary angiotensinogen (uAGT), urinary neutrophil
gelatinase-associated lipocalin (uNGAL), plasma neutrophil gelatinase-associated
lipocalin, urinary IL-18 (uIL-18), urinary kidney injury molecule-1, and urinary
albumin-to-creatinine ratio, were measured at time of AKI diagnosis. The primary
outcome was AKI progression defined by worsening of AKI stage (50 patients). The
secondary outcome was AKI progression with subsequent death (18 patients).
RESULTS: After multivariable adjustment, the highest tertile of three urinary
biomarkers remained associated with AKI progression compared with the lowest
tertile: uAGT (odds ratio [OR], 10.8; 95% confidence interval [95% CI], 3.4 to
34.7), uNGAL (OR, 4.7; 95% CI, 1.7 to 13.4), and uIL-18 (OR, 3.6; 95% CI, 1.4 to
9.5). uAGT was the best predictor for both primary and secondary outcomes with
area under the receiver operating curve of 0.78 and 0.85. These three biomarkers
improved risk reclassification compared with the clinical model alone, with uAGT
performing the best (category-free net reclassification improvement for primary
and secondary outcomes of 0.76 [95% CI, 0.46 to 1.06] and 0.93 [95% CI, 0.50 to
1.36]; P<0.001). Excellent performance of uAGT was further confirmed with
bootstrap internal validation. CONCLUSIONS: uAGT, uNGAL, and uIL-18 measured at
time of AKI diagnosis improved risk stratification and identified CRS patients at
highest risk of adverse outcomes.