Urinary cell cycle arrest biomarkers and chitinase 3-like protein 1 (CHI3L1) to detect acute kidney injury in the critically ill: a post hoc laboratory analysis on the FINNAKI cohort

Autor: Hoste, Eric, The FINNAKI Study Group, [missing], Vaara, Suvi T., De Loor, Jorien, Haapio, Mikko, Nuytinck, Lieve, Demeyere, Kristel, Pettilä, Ville, Meyer, Evelyne
Přispěvatelé: HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, University of Helsinki, Helsinki University Hospital Area, HUS Abdominal Center, Nefrologian yksikkö, Department of Medicine, Department of Diagnostics and Therapeutics
Rok vydání: 2020
Předmět:
Male
Letter
030204 cardiovascular system & hematology
Kidney
urologic and male genital diseases
GUIDELINES
Critical Care and Intensive Care Medicine
Likelihood ratios in diagnostic testing
0302 clinical medicine
Medicine and Health Sciences
Clinical endpoint
EPIDEMIOLOGY
FAILURE
Prospective Studies
Biological markers
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Acute kidney injury
Area under the curve
Middle Aged
female genital diseases and pregnancy complications
Lipocalins
3. Good health
Cohort
Biomarker (medicine)
Female
medicine.medical_specialty
YKL-40
Critical Illness
Urinary system
03 medical and health sciences
INFLAMMATION
Internal medicine
Intensive care
medicine
Humans
Chitinase-3-Like Protein 1
Aged
SEPSIS
business.industry
Chitinase
NephroCheck
030208 emergency & critical care medicine
Cell Cycle Checkpoints
lcsh:RC86-88.9
3126 Surgery
anesthesiology
intensive care
radiology
medicine.disease
MARKER
business
Biomarkers
Zdroj: CRITICAL CARE
Critical Care, Vol 24, Iss 1, Pp 1-10 (2020)
Critical Care
ISSN: 1364-8535
1466-609X
Popis: Background Acute kidney injury (AKI) is a frequently occurring syndrome in critically ill patients and is associated with worse outcomes. Biomarkers allow early identification and therapy of AKI which may improve outcomes. Urine chitinase 3-like protein 1 (uCHI3L1) was recently identified as a promising urinary biomarker for AKI. In this multicenter study, we evaluated the diagnostic performance for AKI stage 2 or greater of uCHI3L1 in comparison with the urinary cell cycle arrest biomarkers urinary tissue inhibitor of metalloproteinases-2 (TIMP-2)•insulin-like growth factor-binding protein 7 (IGFBP7) measured by NephroCheck Risk®. Methods Post hoc laboratory study of the prospective observational FINNAKI study. Of this cohort, we included patients with stored admission urine samples and availability of serum creatinine at day 1 of admission. Patients who already had AKI stage 2 or 3 at ICU admission were excluded. AKI was defined and staged according to the KDIGO definition and staging system. The primary endpoint was AKI stage 2 or 3 at day 1. Biomarker performance was assessed by the area under the curve of the receiver operating characteristic curve (AUC). We assessed individual performance and different combinations of urine biomarkers. Results Of 660 included patients, 49 (7.4%) had AKI stages 2–3 at day 1. All urine biomarkers were increased at admission in AKI patients. All biomarkers and most combinations had AUCs Conclusions We found that uCHI3L1 and NephroCheck Risk® had a comparable diagnostic performance for diagnosis of AKI stage 2 or greater within a 24-h period in this multicenter FINNAKI cohort. In contrast to initial discovery and validation studies, the diagnostic performance was poor. Possible explanations for this observation are differences in patient populations, proportion of emergency admissions, proportion of functional AKI, rate of developing AKI, and observation periods for diagnosis of AKI.
Databáze: OpenAIRE
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