@article{3fc900e793434f4682741626dfb5a363,
title = "Results from the TRIBE-AKI Study found associations between post-operative blood biomarkers and risk of chronic kidney disease after cardiac surgery",
abstract = "Patients undergoing cardiac surgery are placed under intense physiologic stress. Blood and urine biomarkers measured peri-operatively may help identify patients at higher risk for adverse long-term kidney outcomes.We sought to determine independent associations of various biomarkers with development or progression of chronic kidney disease (CKD) following cardiac surgery. In this sub-study of the prospective cohort –TRIBE-AKI Study, we evaluated 613 adult patients undergoing cardiac surgery in Canada in our primary analysis and tested the association of 40 blood and urinary biomarkers with the primary composite outcome of CKD incidence or progression. In those with baseline estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73m2, we defined CKD incidence as a 25% reduction in eGFR and an eGFR under 60. In those with baseline eGFR under 60 mL/min/1.73m2, we defined CKD progression as a 50% reduction in eGFR or eGFR under 15. Results were evaluated in a replication cohort of 310 patients from one study site in the United States. Over a median follow-up of 5.6 years, 172 patients developed the primary outcome. Each log increase in basic fibroblast growth factor (adjusted hazard ratio 1.52 [95% confidence interval 1.19, 1.93]), Kidney Injury Molecule-1 (1.51 [0.98, 2.32]), N-terminal pro–B-type natriuretic peptide (1.19 [1.01, 1.41]), and tumor necrosis factor receptor 1 (1.75 [1.18, 2.59]) were associated with outcome after adjustment for demographic factors, serum creatinine, and albuminuria. Similar results were noted in the replication cohort. Although there was no interaction by acute kidney injury in continuous analysis, mortality was higher in the no acute kidney injury group by biomarker tertile. Thus, elevated post-operative levels of blood biomarkers following cardiac surgery were independently associated with the development of CKD. These biomarkers can provide additional value in evaluating CKD incidence and progression after cardiac surgery.",
keywords = "CKD, biomarkers, cardiac surgery, subclinical AKI",
author = "Steven Menez and Moledina, {Dennis G.} and Garg, {Amit X.} and Heather Thiessen-Philbrook and Eric McArthur and Yaqi Jia and Caroline Liu and Wassim Obeid and Mansour, {Sherry G.} and Koyner, {Jay L.} and Shlipak, {Michael G.} and Wilson, {Francis P.} and Coca, {Steven G.} and Parikh, {Chirag R.}",
note = "Funding Information: SM was supported by the National Institutes of Health (NIH) T32 grant HL007024. DGM was supported by the NIH K23 grant K23DK117065 and by the Yale O{\textquoteright}Brien Kidney Center grant P30DK079310. SGM was supported by the AHA grant 18CDA34110151 and Patterson Trust Fund. NIH (grant R01 HL085757 to CRP) funded the Translational Research Investigating Biomarker Endpoints in Acute Chronic Injury Consortium. CRP was supported by the NIH grant K24DK090203 and P30DK079310 O{\textquoteright}Brien Kidney Center Grant. SGC received salary support from NIH grants R01 DK115562, UO1 DK106962, R01 HL085757, R01 DK112258, and U01 OH011326. FPW was supported by the NIH grant R01 DK113191. JLK was supported by the NIH grant R21 DK113420. SGC, AXG, and CRP are members of the NIH-sponsored Assessment, Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury Consortium (U01-DK-082185). This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. Furthermore, these funding organizations had no role in the study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication. Funding Information: SM was supported by the National Institutes of Health (NIH) T32 grant HL007024. DGM was supported by the NIH K23 grant K23DK117065 and by the Yale O'Brien Kidney Center grant P30DK079310. SGM was supported by the AHA grant 18CDA34110151 and Patterson Trust Fund. NIH (grant R01 HL085757 to CRP) funded the Translational Research Investigating Biomarker Endpoints in Acute Chronic Injury Consortium. CRP was supported by the NIH grant K24DK090203 and P30DK079310 O'Brien Kidney Center Grant. SGC received salary support from NIH grants R01 DK115562, UO1 DK106962, R01 HL085757, R01 DK112258, and U01 OH011326. FPW was supported by the NIH grant R01 DK113191. JLK was supported by the NIH grant R21 DK113420. SGC, AXG, and CRP are members of the NIH-sponsored Assessment, Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury Consortium (U01-DK-082185). This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. Furthermore, these funding organizations had no role in the study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication. SM and CRP led all stages of the work in collaboration with DGM, AXG, HT-P, EM, YJ, CL, WO, SGM, JLK, MGS, FPW, and SGC. AXG, SGC, and CRP were responsible for the study design. HT-P, EM, YJ, and CL contributed significantly to data analysis and preparation of figures. All authors contributed to drafting and critical revision of the manuscript for intellectual content before approving the final version. Funding Information: MGS has received grant support from Cricket Health, has received consultancy fees from the University of Washington, and has equity in TAI Diagnostics and Cricket Health. SGC and CRP are members of the advisory board of Renalytix AI and own equity in the same. In the past 3 years, SGC has received consulting fees from Goldfinch Bio, CHF Solutions, Quark Biopharma, Janssen Pharmaceuticals, Takeda Pharmaceuticals, and Relypsa. JLK has received research fees from Bioporto and Astute Medical and consulting fees from Baxter, Astute Medical, and SphingoTec. All the other authors declared no competing interests. Publisher Copyright: {\textcopyright} 2020 International Society of Nephrology",
year = "2021",
month = mar,
doi = "10.1016/j.kint.2020.06.037",
language = "English (US)",
volume = "99",
pages = "716--724",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "3",
}