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Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery.

Publication ,  Journal Article
Parikh, CR; Thiessen-Philbrook, H; Garg, AX; Kadiyala, D; Shlipak, MG; Koyner, JL; Edelstein, CL; Devarajan, P; Patel, UD; Zappitelli, M ...
Published in: Clin J Am Soc Nephrol
July 2013

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 level was associated with AKI compared with 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 gelatinase-associated lipocalin and IL-18). The highest area under the curves achievable for discrimination for AKI were 0.78 in adults using urine KIM-1 from 6 to 12 hours, urine IL-18 from day 2, and plasma neutrophil gelatinase-associated 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.

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Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

July 2013

Volume

8

Issue

7

Start / End Page

1079 / 1088

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Receptors, Virus
  • ROC Curve
  • Proto-Oncogene Proteins
  • Prospective Studies
  • Prognosis
  • Predictive Value of Tests
  • North America
  • Middle Aged
 

Citation

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Parikh, C. R., Thiessen-Philbrook, H., Garg, A. X., Kadiyala, D., Shlipak, M. G., Koyner, J. L., … TRIBE-AKI Consortium, . (2013). Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery. Clin J Am Soc Nephrol, 8(7), 1079–1088. https://doi.org/10.2215/CJN.10971012
Parikh, Chirag R., Heather Thiessen-Philbrook, Amit X. Garg, Deepak Kadiyala, Michael G. Shlipak, Jay L. Koyner, Charles L. Edelstein, et al. “Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery.Clin J Am Soc Nephrol 8, no. 7 (July 2013): 1079–88. https://doi.org/10.2215/CJN.10971012.
Parikh CR, Thiessen-Philbrook H, Garg AX, Kadiyala D, Shlipak MG, Koyner JL, et al. Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery. Clin J Am Soc Nephrol. 2013 Jul;8(7):1079–88.
Parikh, Chirag R., et al. “Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery.Clin J Am Soc Nephrol, vol. 8, no. 7, July 2013, pp. 1079–88. Pubmed, doi:10.2215/CJN.10971012.
Parikh CR, Thiessen-Philbrook H, Garg AX, Kadiyala D, Shlipak MG, Koyner JL, Edelstein CL, Devarajan P, Patel UD, Zappitelli M, Krawczeski CD, Passik CS, Coca SG, TRIBE-AKI Consortium. Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery. Clin J Am Soc Nephrol. 2013 Jul;8(7):1079–1088.

Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

July 2013

Volume

8

Issue

7

Start / End Page

1079 / 1088

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Receptors, Virus
  • ROC Curve
  • Proto-Oncogene Proteins
  • Prospective Studies
  • Prognosis
  • Predictive Value of Tests
  • North America
  • Middle Aged