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Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study

BACKGROUND: Renal dysfunction is an established predictor of all-cause mortality in intensive care units. This study analyzed the outcomes of coronary care unit (CCU) patients and evaluated several biomarkers of acute kidney injury (AKI), including neutrophil gelatinase-associated lipocalin (NGAL),...

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Autores principales: Chen, Tien-Hsing, Chang, Chih-Hsiang, Lin, Chan-Yu, Jenq, Chang-Chyi, Chang, Ming-Yang, Tian, Ya-Chung, Hung, Cheng-Chieh, Fang, Ji-Tseng, Yang, Chih-Wei, Wen, Ming-Shien, Lin, Fun-Chung, Chen, Yung-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285210/
https://www.ncbi.nlm.nih.gov/pubmed/22384218
http://dx.doi.org/10.1371/journal.pone.0032328
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author Chen, Tien-Hsing
Chang, Chih-Hsiang
Lin, Chan-Yu
Jenq, Chang-Chyi
Chang, Ming-Yang
Tian, Ya-Chung
Hung, Cheng-Chieh
Fang, Ji-Tseng
Yang, Chih-Wei
Wen, Ming-Shien
Lin, Fun-Chung
Chen, Yung-Chang
author_facet Chen, Tien-Hsing
Chang, Chih-Hsiang
Lin, Chan-Yu
Jenq, Chang-Chyi
Chang, Ming-Yang
Tian, Ya-Chung
Hung, Cheng-Chieh
Fang, Ji-Tseng
Yang, Chih-Wei
Wen, Ming-Shien
Lin, Fun-Chung
Chen, Yung-Chang
author_sort Chen, Tien-Hsing
collection PubMed
description BACKGROUND: Renal dysfunction is an established predictor of all-cause mortality in intensive care units. This study analyzed the outcomes of coronary care unit (CCU) patients and evaluated several biomarkers of acute kidney injury (AKI), including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18) and cystatin C (CysC) on the first day of CCU admission. METHODOLOGY/PRINCIPAL FINDINGS: Serum and urinary samples collected from 150 patients in the coronary care unit of a tertiary care university hospital between September 2009 and August 2010 were tested for NGAL, IL-18 and CysC. Prospective demographic, clinical and laboratory data were evaluated as predictors of survival in this patient group. The most common cause of CCU admission was acute myocardial infarction (80%). According to Acute Kidney Injury Network criteria, 28.7% (43/150) of CCU patients had AKI of varying severity. Cumulative survival rates at 6-month follow-up following hospital discharge differed significantly (p<0.05) between patients with AKI versus those without AKI. For predicting AKI, serum CysC displayed an excellent areas under the receiver operating characteristic curve (AUROC) (0.895±0.031, p<0.001). The overall 180-day survival rate was 88.7% (133/150). Multiple Cox logistic regression hazard analysis revealed that urinary NGAL, serum IL-18, Acute Physiology, Age and Chronic Health Evaluation II (APACHE II) and sodium on CCU admission day one were independent risk factors for 6-month mortality. In terms of 6-month mortality, urinary NGAL had the best discriminatory power, the best Youden index, and the highest overall correctness of prediction. CONCLUSIONS: Our data showed that serum CysC has the best discriminative power for predicting AKI in CCU patients. However, urinary NGAL and serum IL-18 are associated with short-term mortality in these critically ill patients.
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spelling pubmed-32852102012-03-01 Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study Chen, Tien-Hsing Chang, Chih-Hsiang Lin, Chan-Yu Jenq, Chang-Chyi Chang, Ming-Yang Tian, Ya-Chung Hung, Cheng-Chieh Fang, Ji-Tseng Yang, Chih-Wei Wen, Ming-Shien Lin, Fun-Chung Chen, Yung-Chang PLoS One Research Article BACKGROUND: Renal dysfunction is an established predictor of all-cause mortality in intensive care units. This study analyzed the outcomes of coronary care unit (CCU) patients and evaluated several biomarkers of acute kidney injury (AKI), including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18) and cystatin C (CysC) on the first day of CCU admission. METHODOLOGY/PRINCIPAL FINDINGS: Serum and urinary samples collected from 150 patients in the coronary care unit of a tertiary care university hospital between September 2009 and August 2010 were tested for NGAL, IL-18 and CysC. Prospective demographic, clinical and laboratory data were evaluated as predictors of survival in this patient group. The most common cause of CCU admission was acute myocardial infarction (80%). According to Acute Kidney Injury Network criteria, 28.7% (43/150) of CCU patients had AKI of varying severity. Cumulative survival rates at 6-month follow-up following hospital discharge differed significantly (p<0.05) between patients with AKI versus those without AKI. For predicting AKI, serum CysC displayed an excellent areas under the receiver operating characteristic curve (AUROC) (0.895±0.031, p<0.001). The overall 180-day survival rate was 88.7% (133/150). Multiple Cox logistic regression hazard analysis revealed that urinary NGAL, serum IL-18, Acute Physiology, Age and Chronic Health Evaluation II (APACHE II) and sodium on CCU admission day one were independent risk factors for 6-month mortality. In terms of 6-month mortality, urinary NGAL had the best discriminatory power, the best Youden index, and the highest overall correctness of prediction. CONCLUSIONS: Our data showed that serum CysC has the best discriminative power for predicting AKI in CCU patients. However, urinary NGAL and serum IL-18 are associated with short-term mortality in these critically ill patients. Public Library of Science 2012-02-22 /pmc/articles/PMC3285210/ /pubmed/22384218 http://dx.doi.org/10.1371/journal.pone.0032328 Text en Chen et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Chen, Tien-Hsing
Chang, Chih-Hsiang
Lin, Chan-Yu
Jenq, Chang-Chyi
Chang, Ming-Yang
Tian, Ya-Chung
Hung, Cheng-Chieh
Fang, Ji-Tseng
Yang, Chih-Wei
Wen, Ming-Shien
Lin, Fun-Chung
Chen, Yung-Chang
Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study
title Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study
title_full Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study
title_fullStr Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study
title_full_unstemmed Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study
title_short Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study
title_sort acute kidney injury biomarkers for patients in a coronary care unit: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285210/
https://www.ncbi.nlm.nih.gov/pubmed/22384218
http://dx.doi.org/10.1371/journal.pone.0032328
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