Predicting acute kidney injury using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac intensive care units.
Predicting acute kidney injury using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac intensive care units.
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DOI：
10.1186/s13054-018-2120-z
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发表时间：
2018-08-18
期刊：
影响因子：
--
通讯作者：
Ozaki Y
中科院分区：
文献类型：
--
作者：
Naruse H;Ishii J;Takahashi H;Kitagawa F;Nishimura H;Kawai H;Muramatsu T;Harada M;Yamada A;Motoyama S;Matsui S;Hayashi M;Sarai M;Watanabe E;Izawa H;Ozaki Y
早期预测急性肾损伤(AKI)有助于及时干预和预防并发症。我们的目的是了解尿肝型脂肪酸结合蛋白(L-FABP)水平在内科(非手术)心脏重症监护病房(CICU)入院时对急性心肌梗死的预测价值，无论是独立的还是联合血清N末端B型利钠肽(NT-ProBNP)水平。我们前瞻性地研究了在内科CICU接受治疗的患者中，L-FABP和NT-ProBNP对急性心肌梗死的预测价值。入院时检测基线尿L-FABP和血清NT-ProBNP。Aki是根据肾脏疾病：改善全球预后标准诊断出来的。我们研究了1273名患者(平均年龄68岁)，其中46%有急性冠脉综合征，38%有急性失代偿性心力衰竭，5%有心律失常，3%有肺动脉高压，2%有急性主动脉综合征，2%有感染性心内膜炎，1%有Takotsubo心肌病。尿L-FABP水平与血清NT-ProBNP水平呈正相关(r = 0.17，p <； 0.0001)。急性心肌梗死224例(17.6%)，其中2期或3期48例。发生急性心肌梗死的患者一周和6个月的死亡率高于未发生急性心肌梗死的患者(分别为p = 0.0002和p = 0.003)。在多因素Logistic回归分析中，L-FABP(p <； 0.0001)和NT-ProBNP(p = 0.006)与急性脑梗塞的发生独立相关。将L-FABP和NT-ProBNP添加到包括已建立的危险因素的基线模型中，进一步改善了重新分类(p <； 0.001)和区分度(p <； 0.01)，超过了基线模型或任何单一生物标志物。入院时尿L-FABP和血清NT-ProBNP水平是急性心肌梗死的独立预测因子，联合使用可提高内科ICU患者急性心肌梗死的早期预测。
The early prediction of acute kidney injury (AKI) can facilitate timely intervention and prevent complications. We aimed to understand the predictive value of urinary liver-type fatty-acid binding protein (L-FABP) levels on admission to medical (non-surgical) cardiac intensive care units (CICUs) for AKI, both independently and in combination with serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. We prospectively investigated the predictive value of L-FABP and NT-proBNP for AKI in a large, heterogeneous cohort of patients treated in medical CICUs. Baseline urinary L-FABP and serum NT-proBNP were measured on admission. AKI was diagnosed according to the Kidney Disease: Improving Global Outcomes criteria. We studied 1273 patients (mean age, 68 years), among whom 46% had acute coronary syndromes, 38% had acute decompensated heart failure, 5% had arrhythmia, 3% had pulmonary hypertension, 2% had acute aortic syndrome, 2% had infective endocarditis, and 1% had Takotsubo cardiomyopathy. Urinary L-FABP levels correlated with serum NT-proBNP levels (r = 0.17, p < 0.0001). AKI occurred in 224 patients (17.6%), including 48 patients with stage 2 or 3 disease. Patients who developed AKI had higher one-week and 6-month mortality than those who did not develop AKI (p = 0.0002 and p = 0.003, respectively). In the multivariate logistic analysis, both L-FABP (p < 0.0001) and NT-proBNP (p = 0.006) were independently associated with the development of AKI. Adding L-FABP and NT-proBNP to a baseline model that included established risk factors further improved reclassification (p < 0.001) and discrimination (p < 0.01) beyond that of the baseline model or any single biomarker individually. Urinary L-FABP and serum NT-proBNP levels on admission are independent predictors of AKI, and when used in combination, improve early prediction of AKI in patients hospitalized at medical CICUs.
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影响因子：
5.4
作者：
Liu Y;He YT;Tan N;Chen JY;Liu YH;Yang DH;Huang SJ;Ye P;Li HL;Ran P;Duan CY;Chen SQ;Zhou YL;Chen PY
通讯作者：
Chen PY
影响因子：
24
作者：
Na, Soo Jin;Chung, Chi Ryang;Yang, Jeong Hoon
通讯作者：
Yang, Jeong Hoon
影响因子：
1.5
作者：
Maeda, Yoshiteru;Suzuki, Atsushi;Itoh, Mitsuyasu
通讯作者：
Itoh, Mitsuyasu
影响因子：
4.6
作者：
Katagiri, Daisuke;Doi, Kent;Noiri, Eisei
通讯作者：
Noiri, Eisei
DOI：
10.1053/j.ajkd.2015.10.019
发表时间：
2016-05
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Heung M;Steffick DE;Zivin K;Gillespie BW;Banerjee T;Hsu CY;Powe NR;Pavkov ME;Williams DE;Saran R;Shahinian VB;Centers for Disease Control and Prevention CKD Surveillance Team
通讯作者：
Centers for Disease Control and Prevention CKD Surveillance Team