Urinary cast is a useful predictor of acute kidney injury in acute heart failure
Urinary cast is a useful predictor of acute kidney injury in acute heart failure
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DOI：
10.1038/s41598-019-39470-1
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发表时间：
2019-03-13
影响因子：
4.6
通讯作者：
Yoshin, Hideaki
中科院分区：
文献类型：
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作者：
Higuchi, Satoshi;Kabeya, Yusuke;Yoshin, Hideaki
急性肾损伤（阿基）与急性心力衰竭（AHF）患者的预后不良相关。通过简单的检查早期记录肾功能受损可能会降低此类患者的风险。本研究旨在揭示细胞管型与AHF患者医院获得性阿基之间的相关性。本研究纳入了入院后24小时内接受尿分析（包括尿沉渣分析）的AHF患者。阿基定义为48小时内血清肌酐水平与基线肌酐水平相比升高≥ 0.3 mg/dL或≥ 1.5倍。在这项研究中，纳入了114例AHF患者（年龄，75 ± 14岁;男性，59.7%）。其中，40例（35%）发生了医院获得性阿基。在发生阿基之前，在30名患者（26%）中检测到细胞管型，并在多变量logistic回归分析中与医院获得性阿基相关（比值比，2.80; 95%置信区间，1.04-7.49; P = 0.041）。总之，在AHF患者中偶尔观察到细胞管型，这可能是住院期间发生阿基的有用标志物。
Acute kidney injury (AKI) is associated with poor prognosis among patients with acute heart failure (AHF). Early documentation of impaired kidney function through simple examination may provide risk reduction in such patients. The present study aims to reveal an association between cellular casts and hospital-acquired AKI in AHF. This study included patients with AHF who underwent urinalysis, including urinary sediment analysis within 24 hours post admission. AKI was defined as an increase of >= 0.3 mg/dL within 48 hours or >= 1.5 times in serum creatinine level in contrast to baseline creatinine level. In this study, 114 patients with AHF (age, 75 +/- 14 years; male, 59.7%) were included. Of them, 40 (35%) developed hospital-acquired AKI. Cellular casts were detected in 30 patients (26%) prior to AKI development and related to hospital-acquired AKI in the multivariate logistic regression analysis (odds ratio, 2.80; 95% confidence interval, 1.04-7.49; P = 0.041). In conclusion, cellular casts are observed occasionally in patients with AHF and potentially useful markers for development of AKI during hospitalization.