@article{a319ca1128684fbe94d25873ed62fa5f,
title = "Perioperative heart-type fatty acid binding protein is associated with acute kidney injury after cardiac surgery",
abstract = "Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Since heart fatty acid binding protein (H-FABP) is a myocardial protein that detects cardiac injury, we sought to determine whether plasma H-FABP was associated with AKI in the TRIBE-AKI cohort; a multi-center cohort of 1219 patients at high risk for AKI who underwent cardiac surgery. The primary outcomes of interest were any AKI (Acute Kidney Injury Network (AKIN) stage 1 or higher) and severe AKI (AKIN stage 2 or higher). The secondary outcome was long-term mortality after discharge. Patients who developed AKI had higher levels of H-FABP pre- and postoperatively than patients who did not have AKI. In analyses adjusted for known AKI risk factors, first postoperative log(H-FABP) was associated with severe AKI (adjusted odds ratio (OR) 5.39 (95% confidence interval (CI), 2.87-10.11) per unit increase), while preoperative log(H-FABP) was associated with any AKI (2.07 (1.48-2.89)) and mortality (1.67 (1.17-2.37)). These relationships persisted after adjustment for change in serum creatinine (for first postoperative log(H-FABP)) and biomarkers of cardiac and kidney injury, including brain natriuretic peptide, cardiac troponin-I, interleukin-18, liver fatty acid binding protein, kidney injury molecule-1, and neutrophil gelatinase-associated lipocalin. Thus, perioperative plasma H-FABP levels may be used for risk stratification of AKI and mortality following cardiac surgery.",
keywords = "acute kidney injury, cardiac surgery, heart-type fatty acid binding protein, mortality",
author = "Schaub, {Jennifer A.} and Garg, {Amit X.} and Coca, {Steven G.} and Testani, {Jeffrey M.} and Shlipak, {Michael G.} and John Eikelboom and Peter Kavsak and Eric Mcarthur and Colleen Shortt and Richard Whitlock and Parikh, {Chirag R.}",
note = "Funding Information: Members of the TRIBE-AKI Consortium are as follows: Dr Jay Koyner (University of Chicago); Dr Prasad Devarajan (University of Cincinnati Children{\textquoteright}s Hospital); Dr Charles Edelstein (University of Colorado); Dr Cary Passik (Danbury Hospital); Dr Madhav Swaminathan and Dr Uptal Patel (Duke University); and Dr Michael Zappitelli (Montreal Children{\textquoteright}s Hospital). This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results, and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. This study was supported by the National Institutes of Health (NIH) (R01HL085757 to CRP) to fund the TRIBE-AKI Consortium to study novel biomarkers of AKI in cardiac surgery. CRP is supported by the NIH (K24DK090203) and P30 DK079310 O'Brien Center Grant. SGC, AXG, and CRP are also members of the NIH-sponsored Assess, Serial Evaluation and Subsequent Sequelae in Acute Kidney Consortium (U01DK082185). JMT is supported by K23HL114868 and L30HL115790. The H-FABP, BNP, and cardiac troponin I assays were donated by Randox, Biosite, and Beckman Coulter, respectively. The urine biomarker assays were donated by Abbott Diagnostics (IL-18 and NGAL) and Sekisui Diagnostics LLC (KIM-1 and L-FABP). The granting agencies, Randox Diagnostics, Biosite, Beckman Coulter, Abbott Diagnostics, and Sekisui Diagnostics did not participate in the design of conduct of the study, collection, management, analysis, and interpretation of the data, and preparation, review, or approval of the manuscript. The Institute for Clinical Evaluative Sciences receives funding from the Ontario Ministry of Health and Long-Term Care. The opinions, results, and conclusions reported in this article are those of the authors and are independent of the funding sources. The results presented in this article have not been published previously in whole or part, except in abstract form. Publisher Copyright: {\textcopyright} 2015 International Society of Nephrology.",
year = "2015",
month = sep,
day = "3",
doi = "10.1038/ki.2015.104",
language = "English (US)",
volume = "88",
pages = "576--583",
journal = "Kidney international",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "3",
}