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Kinetic eGFR and Novel AKI Biomarkers to Predict Renal Recovery

dc.rights.licenseopenen_US
dc.contributor.authorDEWITTE, A.
dc.contributor.authorJOANNES-BOYAU, O.
dc.contributor.authorSIDOBRE, C.
dc.contributor.authorFLEUREAU, C.
dc.contributor.authorBATS, M. L.
dc.contributor.authorDERACHE, P.
dc.contributor.authorLEUILLET, S.
dc.contributor.authorRIPOCHE, J.
dc.contributor.authorCOMBE, C.
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorOUATTARA, A.
dc.date.accessioned2020-10-27T13:34:05Z
dc.date.available2020-10-27T13:34:05Z
dc.date.issued2015-11
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/11504
dc.description.abstractEnBACKGROUND AND OBJECTIVES: Prompt recognition of severe renal impairment could improve the early management of critically ill patients. We compared the value of kinetic eGFR, plasma neutrophil gelatinase-associated lipocalin (NGAL), and urine tissue inhibitor of metalloproteinase-2 and urine insulin-like growth factor-binding protein 7 ([TIMP-2]*[IGFBP7]) in predicting short-term recovery from AKI and major adverse kidney events. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: During the 6-month study period, 245 patients were admitted to our intensive care unit. This study included 57 consecutive patients presenting with AKI within the first 24 hours after admission. AKI markers were evaluated at inclusion (day 0) and 24 hours later (day 1). Kinetic eGFR was calculated on day 1 according to serum creatinine evolution. Renal recovery was defined as normalization of serum creatinine with reversal of oliguria within 48 hours. Major adverse kidney events included death, need for RRT, or persistence of renal dysfunction at hospital discharge. RESULTS: Plasma NGAL and [TIMP-2]*[IGFBP7] predicted renal recovery, with area under the receiver-operating characteristic curve (AUC-ROC) values between 0.70 and 0.79 at inclusion. Although plasma NGAL values frequently reached the maximal measurement range, their decrease on day 1 predicted recovery. The kinetic eGFR calculation after initial resuscitation provided the best AUC-ROC value for renal recovery, at 0.87. The best predictions for major adverse kidney events were provided by [TIMP-2]*[IGFBP7] and kinetic eGFR (equal AUC-ROCs of 0.81). Combining AKI markers in addition to clinical prediction models improved the discrimination and reclassification of patients who will recover from AKI or suffer from major adverse kidney events. CONCLUSIONS: Biomarkers of kidney damage predicted short-term renal recovery and major adverse kidney events for an unselected cohort of critically ill patients. Calculating the kinetic eGFR imposed a delay after initial resuscitation but provided a good diagnostic and prognostic approach. The utility of functional and damage AKI marker combinations in addition to clinical information requires validation in larger prospective studies.
dc.language.isoENen_US
dc.subjectArticle CLINIQUE
dc.subject.enAki
dc.subject.enBiomarkers
dc.subject.enDoppler Ultrasonography
dc.subject.enNeutrophil Gelatinase–Associated Lipocalin
dc.subject.enNgal
dc.title.enKinetic eGFR and Novel AKI Biomarkers to Predict Renal Recovery
dc.title.alternativeClin J Am Soc Nephrolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.2215/CJN.12651214en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalClinical journal of the American Society of Nephrologyen_US
bordeaux.page1900–1910en_US
bordeaux.volume10en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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