دورية أكاديمية
Elevated urinary Kidney Injury Molecule 1 (KIM-1) at discharge strongly predicts early mortality following an episode of acute decompensated heart failure
| العنوان: | Elevated urinary Kidney Injury Molecule 1 (KIM-1) at discharge strongly predicts early mortality following an episode of acute decompensated heart failure |
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| المؤلفون: | Josa-Laorden, Claudia, Rubio-Gracia, Jorge, Sánchez-Marteles, Marta, Torcal, Pilar, Garcés-Horna, Vanesa, Sola-Martínez, Anna, Íñigo, Pablo, Giménez-López, Ignacio, Pérez-Calvo, Juan I. |
| سنة النشر: | 2022 |
| المجموعة: | Digital Repository of University of Zaragoza (ZAGUAN) |
| الوصف: | Introduction: Hospitalization for Acute Decompensation of Heart Failure (ADHF) is a frequent event associated with long-term adverse effects. Prognosis is even worse if Acute Kidney Injury (AKI) occurs during hospitalization. Objectives: To determine whether kidney damage biomarkers NGAL, KIM-1 and IL-18 might predict AKI and have prognostic value of in ADHF. Patients and methods: Serum NGAL on admission and urine NGAL, KIM-1 and IL-18 on discharge were determined in 187 ADHF patients enrolled in a prospective, observational, unblinded study. AKI was diagnosed using the KDIGO criteria. Patients were followed-up for 12 months to record all-cause mortality. Results: 22% patients died during follow-up, with 52.5% dying within 4 months after discharge. Serum NGAL (P <0.001), urine NGAL (P = 0.047), and urinary KIM-1 (P = 0.014) levels were significantly higher in deceased patients at discharge. After adjustment for eGFR, only urinary KIM-1 independently predicted mortality at month 4 (HR 3.166, 95%CI 1.203-8.334, P = 0.020) and month 12 (HR 1.969, 95%CI 1.123-3.454, P = 0.018) in Cox regression models. In ROC analysis urinary KIM-1 (AUC = 0.830) outperformed other markers of renal function. Kaplan-Meier survival analysis showed KIM-1 predictive value is additive to that of AKI incidence and admission eGFR. Admission serum NGAL was higher in AKI patients (P ≤0.001) with a modest diagnostic performance (AUC = 0.667), below urea (AUC = 0.732), creatinine (AUC = 0.696), or CysC (AUC = 0.676). Conclusions: Discharge urinary KIM-1 was a strong and independent predictor of mortality, particularly during the most vulnerable period shortly after hospitalization. Admission serum NGAL was inferior to conventional renal function parameters in predicting AKI during ADHF. Introducción: La hospitalización por descompensación aguda de insuficiencia cardíaca (ICAD) es un evento frecuente asociado a efectos adversos a largo plazo. El pronóstico es aún peor si se produce una lesión renal aguda (IRA) durante la hospitalización. ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | info:eu-repo/grantAgreement/ES/DGA/B07-20R; info:eu-repo/grantAgreement/ES/ISCIII/PI12-00694; http://zaguan.unizar.es/record/118707Test |
| DOI: | 10.20452/pamw.16284 |
| الإتاحة: | https://doi.org/10.20452/pamw.16284Test http://zaguan.unizar.es/record/118707Test |
| حقوق: | by-nc-nd ; http://creativecommons.org/licenses/by-nc-nd/3.0/esTest/ |
| رقم الانضمام: | edsbas.7FC3F2F6 |
| قاعدة البيانات: | BASE |
| DOI: | 10.20452/pamw.16284 |
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