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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | De Loor, Jorien Decruyenaere, Johan Demeyere, Kristel Nuytinck, Lieve Hoste, Eric AJ Meyer, Evelyne |
| Abstract | Background Acute kidney injury (AKI) occurs frequently and adversely affects patient and kidney outcomes, especially when its severity increases from stage 1 to stages 2 or 3. Early interventions may counteract such deterioration, but this requires early detection. Our aim was to evaluate whether the novel renal damage biomarker urinary chitinase 3-like protein 1 (UCHI3L1) can detect AKI stage ≥2 more early than serum creatinine and urine output, using the respective Kidney Disease | Improving Global Outcomes (KDIGO) criteria for definition and classification of AKI, and compare this to urinary neutrophil gelatinase-associated lipocalin (UNGAL). Methods This was a translational single-center, prospective cohort study at the 22-bed surgical and 14-bed medical intensive care units (ICU) of Ghent University Hospital. We enrolled 181 severely ill adult patients who did not yet have AKI stage ≥2 based on the KDIGO criteria at time of enrollment. The concentration of creatinine (serum, urine) and CHI3L1 (serum, urine) was measured at least daily, and urine output hourly, in the period from enrollment till ICU discharge with a maximum of 7 ICU-days. The concentration of UNGAL was measured at enrollment. The primary endpoint was the development of AKI stage ≥2 within 12 h after enrollment. Results After enrollment, 21 (12 %) patients developed AKI stage ≥2 within the next 7 days, with 6 (3 %) of them reaching this condition within the first 12 h. The enrollment concentration of UCHI3L1 predicted the occurrence of AKI stage ≥2 within the next 12 h with a good AUC-ROC of 0.792 (95 % CI: 0.726–0.849). This performance was similar to that of UNGAL (AUC-ROC of 0.748 (95 % CI: 0.678–0.810)). Also, the samples collected in the 24-h time frame preceding diagnosis of the 1st episode of AKI stage ≥2 had a 2.0 times higher (95 % CI: 1.3–3.1) estimated marginal mean of UCHI3L1 than controls. We further found that increasing UCHI3L1 concentrations were associated with increasing AKI severity. Conclusions In this pilot study we found that UCHI3L1 was a good biomarker for prediction of AKI stage ≥2 in adult ICU patients. |
| Related Links | https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-016-1192-x.pdf |
| Ending Page | 14 |
| Page Count | 14 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 13648535 |
| DOI | 10.1186/s13054-016-1192-x |
| Journal | Critical Care |
| Issue Number | 1 |
| Volume Number | 20 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2016-02-11 |
| Access Restriction | Open |
| Subject Keyword | Intensive Critical Care Medicine Emergency Medicine Acute kidney injury Biological markers Chitinase Intensive care Lipocalins |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine |
| Journal Impact Factor | 8.8/2023 |
| 5-Year Journal Impact Factor | 10.4/2023 |
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