External validation of urinary C-C motif chemokine ligand 14 (CCL14) for prediction of persistent acute kidney injury
Bagshaw, Sean M. (University of Alberta)
Al-Khafaji, Ali (University of Pittsburgh)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Davison, Danielle (George Washington University)
Haase, Michael (Otto Von-Guericke-University Magdeburg)
Lissauer, Matthew (Rutgers-Robert Wood Johnson Medical School)
Zacharowski, Kai (Goethe University)
Chawla, Lakhmir S. (Veterans Affairs Medical Center)
Kwan, Thomas (Astute Medical (Estats Units d'Amèrica))
Kampf, J. Patrick (Astute Medical (Estats Units d'Amèrica))
McPherson, Paul (Astute Medical (Estats Units d'Amèrica))
Kellum, John A. (University of Pittsburgh)
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	Persistent acute kidney injury (AKI) portends worse clinical outcomes and remains a therapeutic challenge for clinicians. A recent study found that urinary C-C motif chemokine ligand 14 (CCL14) can predict the development of persistent AKI. We aimed to externally validate urinary CCL14 for the prediction of persistent AKI in critically ill patients. This was a secondary analysis of the prospective multi-center SAPPHIRE study. We evaluated critically ill patients with cardiac and/or respiratory dysfunction who developed Kidney Disease: Improving Global Outcomes (KDIGO) stage 2-3 AKI within one week of enrollment. The main exposure was the urinary concentration of CCL14 measured at the onset of AKI stage 2-3. The primary endpoint was the development of persistent severe AKI, defined as ≥ 72 h of KDIGO stage 3 AKI or death or renal-replacement therapy (RRT) prior to 72 h. The secondary endpoint was a composite of RRT and/or death by 90 days. We used receiver operating characteristic (ROC) curve analysis to assess discriminative ability of urinary CCL14 for the development of persistent severe AKI and multivariate analysis to compare tertiles of urinary CCL14 and outcomes. We included 195 patients who developed KDIGO stage 2-3 AKI. Of these, 28 (14%) developed persistent severe AKI, of whom 15 had AKI ≥ 72 h, 12 received RRT and 1 died prior to ≥ 72 h of KDIGO stage 3 AKI. Persistent severe AKI was associated with chronic kidney disease, diabetes mellitus, higher non-renal APACHE III score, greater fluid balance, vasopressor use, and greater change in baseline serum creatinine. The AUC for urinary CCL14 to predict persistent severe AKI was 0. 81 (95% CI, 0. 72-0. 89). The risk of persistent severe AKI increased with higher values of urinary CCL14. RRT and/or death at 90 days increased within tertiles of urinary CCL14 concentration. This secondary analysis externally validates urinary CCL14 to predict persistent severe AKI in critically ill patients. The online version contains supplementary material available.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Acute kidney injury ; Prediction ; Validation ; Renal replacement therapy ; Mortality
Publicado en:	Critical Care, Vol. 25 (may 2021) , ISSN 1466-609X

DOI: 10.1186/s13054-021-03618-1
PMID: 34059102

8 p, 961.6 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Instituto de Investigación e Innovación Parc Taulí (I3PT)
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