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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/16010

Title: Novel Urinary Biomarkers in Detecting Acute Kidney Injury, Persistent Renal Impairment, and All-Cause Mortality Following Decongestive Therapy in Acute Decompensated Heart Failure
Authors: VERBRUGGE, Frederik
Dupont, Matthias
Shao, Zhili
Shrestha, Kevin
Singh, Dhssraj
Finucan, Michael
MULLENS, Wilfried
Tang, W. H. Wilson
Issue Date: 2013
Citation: JOURNAL OF CARDIAC FAILURE, 19 (9), p. 621-628
Abstract: Background: New urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18), are proposed to allow a more reliable early diagnosis and prognosis of acute kidney injury (AM) in acute decompensated heart failure (ADHF). Our aim was to compare the predictive value of urinary NGAL, KIM-1, and IL-18 for the occurrence of AM, persistent renal impairment, and mortality in ADHF. Methods and Results: Eighty-three patients admitted for ADHF were analyzed. Urinary creatinine (Cr), NGAL, KIM-1, and IL-18 were measured at baseline. Serum Cr was measured daily during the next 4 days and again at outpatient follow-up after 6 months. Mortality data were prospectively collected. Urinary NGAL, KIM-1, and IL-18 were modestly correlated with each other (Spearman rho <= 0.61) and poorly correlated with estimated glomerular filtration rate (eGFR; Spearman rho <= 0.28). None predicted AM, defined as a 25% decrease in eGFR, during the index hospitalization, but urinary IL-18/Cr was the strongest predictor of persistently elevated serum Cr >= 0.3 mg/dL after 6 months compared with baseline (area under the receiver operating characteristic curve 0.674; P = .013). Urinary IL-18 was also significantly associated with all-cause mortality (hazard ratio 1.48, 95% confidence interval 1.16-1.87; P = .001). Conclusions: Like urinary NGAL, urinary KIM-1 and IL-18 are relatively modest predictors of AM in ADHF. Among these novel renal biomarkers examined, further investigations regarding the prognostic value of urinary IL-18 are warranted.
URI: http://hdl.handle.net/1942/16010
DOI: 10.1016/j.cardfail.2013.07.004
ISI #: 000326304500004
ISSN: 1071-9164
Category: A1
Type: Journal Contribution
Validation: ecoom, 2014
Appears in Collections: Research publications

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