Abstract
Background and objectives AKI is common and novel biomarkers may help provide earlier diagnosis and prognosis of AKI in the postoperative period. Design, setting, participants, & measurements This was a prospective, multicenter cohort study involving 1219 adults and 311 children consecutively enrolled at eight academic medical centers. Performance of two urine biomarkers, kidney injury molecule-1 (KIM-1) and liver fatty acid-binding protein (L-FABP), alone or in combination with other injury biomarkers during the perioperative period was evaluated. AKI was defined as doubling of serum creatinine or need for acute dialysis. Results KIM-1 peaked 2 days after surgery in adults and 1 day after surgery in children,whereas L-FABP peaked within 6 hours after surgery in both age groups. In multivariable analyses, the highest quintile of the first postoperative KIM-1 levelwas associatedwithAKI comparedwith the lowest quintile in adults,whereas the first postoperative L-FABP was not associated with AKI. Both KIM-1 and L-FABP were not significantly associated with AKI in adults or children after adjusting for other kidney injury biomarkers (neutrophil gelatinaseassociated lipocalin and IL-18). The highest area under the curves achievable for discrimination forAKI were 0.78 in adults using urine KIM-1 from 6 to 12 hours, urine IL-18 from day 2, and plasma neutrophil gelatinaseassociated lipocalin from day 2 and 0.78 in children using urine IL-18 from 0 to 6 hours and urine L-FABP from day 2. Conclusions Postoperative elevations of KIM-1 associate with AKI and adverse outcmes in adults but were not independent of other AKI biomarkers. A panel of multiple biomarkers provided moderate discrimination for AKI.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1079-1088 |
| Number of pages | 10 |
| Journal | Clinical Journal of the American Society of Nephrology |
| Volume | 8 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2013 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Nephrology
- Transplantation
- Epidemiology
- Critical Care and Intensive Care Medicine
Cite this
Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of aki after cardiac surgery. / Parikh, Chirag; Thiessen Philbrook, Heather; Garg, Amit X.; Kadiyala, Deepak; Shlipak, Michael G.; Koyner, Jay L.; Edelstein, Charles L.; Devarajan, Prasad; Patel, Uptal D.; Zappitelli, Michael; Krawczeski, Catherine D.; Passik, Cary S.; Coca, Steven G.
In: Clinical Journal of the American Society of Nephrology, Vol. 8, No. 7, 01.07.2013, p. 1079-1088.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of aki after cardiac surgery
AU - Parikh, Chirag
AU - Thiessen Philbrook, Heather
AU - Garg, Amit X.
AU - Kadiyala, Deepak
AU - Shlipak, Michael G.
AU - Koyner, Jay L.
AU - Edelstein, Charles L.
AU - Devarajan, Prasad
AU - Patel, Uptal D.
AU - Zappitelli, Michael
AU - Krawczeski, Catherine D.
AU - Passik, Cary S.
AU - Coca, Steven G.
PY - 2013/7/1
Y1 - 2013/7/1
N2 - Background and objectives AKI is common and novel biomarkers may help provide earlier diagnosis and prognosis of AKI in the postoperative period. Design, setting, participants, & measurements This was a prospective, multicenter cohort study involving 1219 adults and 311 children consecutively enrolled at eight academic medical centers. Performance of two urine biomarkers, kidney injury molecule-1 (KIM-1) and liver fatty acid-binding protein (L-FABP), alone or in combination with other injury biomarkers during the perioperative period was evaluated. AKI was defined as doubling of serum creatinine or need for acute dialysis. Results KIM-1 peaked 2 days after surgery in adults and 1 day after surgery in children,whereas L-FABP peaked within 6 hours after surgery in both age groups. In multivariable analyses, the highest quintile of the first postoperative KIM-1 levelwas associatedwithAKI comparedwith the lowest quintile in adults,whereas the first postoperative L-FABP was not associated with AKI. Both KIM-1 and L-FABP were not significantly associated with AKI in adults or children after adjusting for other kidney injury biomarkers (neutrophil gelatinaseassociated lipocalin and IL-18). The highest area under the curves achievable for discrimination forAKI were 0.78 in adults using urine KIM-1 from 6 to 12 hours, urine IL-18 from day 2, and plasma neutrophil gelatinaseassociated lipocalin from day 2 and 0.78 in children using urine IL-18 from 0 to 6 hours and urine L-FABP from day 2. Conclusions Postoperative elevations of KIM-1 associate with AKI and adverse outcmes in adults but were not independent of other AKI biomarkers. A panel of multiple biomarkers provided moderate discrimination for AKI.
AB - Background and objectives AKI is common and novel biomarkers may help provide earlier diagnosis and prognosis of AKI in the postoperative period. Design, setting, participants, & measurements This was a prospective, multicenter cohort study involving 1219 adults and 311 children consecutively enrolled at eight academic medical centers. Performance of two urine biomarkers, kidney injury molecule-1 (KIM-1) and liver fatty acid-binding protein (L-FABP), alone or in combination with other injury biomarkers during the perioperative period was evaluated. AKI was defined as doubling of serum creatinine or need for acute dialysis. Results KIM-1 peaked 2 days after surgery in adults and 1 day after surgery in children,whereas L-FABP peaked within 6 hours after surgery in both age groups. In multivariable analyses, the highest quintile of the first postoperative KIM-1 levelwas associatedwithAKI comparedwith the lowest quintile in adults,whereas the first postoperative L-FABP was not associated with AKI. Both KIM-1 and L-FABP were not significantly associated with AKI in adults or children after adjusting for other kidney injury biomarkers (neutrophil gelatinaseassociated lipocalin and IL-18). The highest area under the curves achievable for discrimination forAKI were 0.78 in adults using urine KIM-1 from 6 to 12 hours, urine IL-18 from day 2, and plasma neutrophil gelatinaseassociated lipocalin from day 2 and 0.78 in children using urine IL-18 from 0 to 6 hours and urine L-FABP from day 2. Conclusions Postoperative elevations of KIM-1 associate with AKI and adverse outcmes in adults but were not independent of other AKI biomarkers. A panel of multiple biomarkers provided moderate discrimination for AKI.
UR - http://www.scopus.com/inward/record.url?scp=84879833615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879833615&partnerID=8YFLogxK
U2 - 10.2215/CJN.10971012
DO - 10.2215/CJN.10971012
M3 - Article
C2 - 23599408
AN - SCOPUS:84879833615
VL - 8
SP - 1079
EP - 1088
JO - Clinical journal of the American Society of Nephrology : CJASN
JF - Clinical journal of the American Society of Nephrology : CJASN
SN - 1555-9041
IS - 7
ER -