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Dickkopf-3 in the prediction of contrast media induced acute kidney injury
BACKGROUND: Dickkopf-3 (DKK3) has recently been discovered as a urinary biomarker for the prediction of acute kidney injury (AKI) after cardiac surgery. This finding needs to be confirmed for AKI in other clinical settings. The present study investigates whether DKK3 can predict contrast-induced AKI...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192364/ https://www.ncbi.nlm.nih.gov/pubmed/33275197 http://dx.doi.org/10.1007/s40620-020-00910-1 |
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author | Seibert, Felix S. Heringhaus, Anja Pagonas, Nikolaos Rohn, Benjamin Bauer, Frederic Trappe, Hans-Joachim Landmesser, Ulf Babel, Nina Westhoff, Timm H. |
author_facet | Seibert, Felix S. Heringhaus, Anja Pagonas, Nikolaos Rohn, Benjamin Bauer, Frederic Trappe, Hans-Joachim Landmesser, Ulf Babel, Nina Westhoff, Timm H. |
author_sort | Seibert, Felix S. |
collection | PubMed |
description | BACKGROUND: Dickkopf-3 (DKK3) has recently been discovered as a urinary biomarker for the prediction of acute kidney injury (AKI) after cardiac surgery. This finding needs to be confirmed for AKI in other clinical settings. The present study investigates whether DKK3 can predict contrast-induced AKI (CI-AKI). METHODS: We performed a prospective study in 490 patients undergoing coronary angiography. Primary endpoint was an increase in serum creatinine concentration ≥ 0.3 mg/dl within 72 h after the procedure. DKK3 was assessed < 24 h before coronary angiography. Predictive accuracy was assessed by receiver operating characteristic (ROC) curves. RESULTS: CI-AKI was observed in 30 (6.1%) patients, of whom 27 corresponded to stage I and 3 to stage II according to the Acute Kidney Injury Network (AKIN) criteria. Subjects who developed CI-AKI had a 3.8-fold higher urinary DKK3/creatinine ratio than those without CI-AKI (7.5 pg/mg [interquartile range [IQR] 1.2–1392.0] vs. 2.0 pg/mg [IQR 0.9–174.0]; p = 0.047). ROC analysis revealed an area under the curve (AUC) of 0.61. Among subjects without clinically overt chronic kidney disease (estimated glomerular filtration rate [eGFR] > 60 ml/min, urinary albumin creatinine ratio < 30 mg/g), the DKK3/creatinine ratio was 5.4-fold higher in those with subsequent CI-AKI (7.5 pg/mg [IQR 0.9–590.1] vs. 1.38 pg/mg [IQR 0.8–51.0]; p = 0.007; AUC 0.62). Coronary angiography was associated with a 43 times increase in the urinary DKK3/creatinine ratio. CONCLUSIONS: Urinary DKK3 is an independent predictor of CI-AKI even in the absence of overt chronic kidney disease (CKD). The study thereby expands the findings on DKK3 in the prediction of postoperative loss of kidney function to other entities of AKI. GRAPHIC ABSTRACT: [Image: see text] |
format | Online Article Text |
id | pubmed-8192364 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-81923642021-06-28 Dickkopf-3 in the prediction of contrast media induced acute kidney injury Seibert, Felix S. Heringhaus, Anja Pagonas, Nikolaos Rohn, Benjamin Bauer, Frederic Trappe, Hans-Joachim Landmesser, Ulf Babel, Nina Westhoff, Timm H. J Nephrol Original Article BACKGROUND: Dickkopf-3 (DKK3) has recently been discovered as a urinary biomarker for the prediction of acute kidney injury (AKI) after cardiac surgery. This finding needs to be confirmed for AKI in other clinical settings. The present study investigates whether DKK3 can predict contrast-induced AKI (CI-AKI). METHODS: We performed a prospective study in 490 patients undergoing coronary angiography. Primary endpoint was an increase in serum creatinine concentration ≥ 0.3 mg/dl within 72 h after the procedure. DKK3 was assessed < 24 h before coronary angiography. Predictive accuracy was assessed by receiver operating characteristic (ROC) curves. RESULTS: CI-AKI was observed in 30 (6.1%) patients, of whom 27 corresponded to stage I and 3 to stage II according to the Acute Kidney Injury Network (AKIN) criteria. Subjects who developed CI-AKI had a 3.8-fold higher urinary DKK3/creatinine ratio than those without CI-AKI (7.5 pg/mg [interquartile range [IQR] 1.2–1392.0] vs. 2.0 pg/mg [IQR 0.9–174.0]; p = 0.047). ROC analysis revealed an area under the curve (AUC) of 0.61. Among subjects without clinically overt chronic kidney disease (estimated glomerular filtration rate [eGFR] > 60 ml/min, urinary albumin creatinine ratio < 30 mg/g), the DKK3/creatinine ratio was 5.4-fold higher in those with subsequent CI-AKI (7.5 pg/mg [IQR 0.9–590.1] vs. 1.38 pg/mg [IQR 0.8–51.0]; p = 0.007; AUC 0.62). Coronary angiography was associated with a 43 times increase in the urinary DKK3/creatinine ratio. CONCLUSIONS: Urinary DKK3 is an independent predictor of CI-AKI even in the absence of overt chronic kidney disease (CKD). The study thereby expands the findings on DKK3 in the prediction of postoperative loss of kidney function to other entities of AKI. GRAPHIC ABSTRACT: [Image: see text] Springer International Publishing 2020-12-04 2021 /pmc/articles/PMC8192364/ /pubmed/33275197 http://dx.doi.org/10.1007/s40620-020-00910-1 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Seibert, Felix S. Heringhaus, Anja Pagonas, Nikolaos Rohn, Benjamin Bauer, Frederic Trappe, Hans-Joachim Landmesser, Ulf Babel, Nina Westhoff, Timm H. Dickkopf-3 in the prediction of contrast media induced acute kidney injury |
title | Dickkopf-3 in the prediction of contrast media induced acute kidney injury |
title_full | Dickkopf-3 in the prediction of contrast media induced acute kidney injury |
title_fullStr | Dickkopf-3 in the prediction of contrast media induced acute kidney injury |
title_full_unstemmed | Dickkopf-3 in the prediction of contrast media induced acute kidney injury |
title_short | Dickkopf-3 in the prediction of contrast media induced acute kidney injury |
title_sort | dickkopf-3 in the prediction of contrast media induced acute kidney injury |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192364/ https://www.ncbi.nlm.nih.gov/pubmed/33275197 http://dx.doi.org/10.1007/s40620-020-00910-1 |
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