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https://ahro.austin.org.au/austinjspui/handle/1/17406
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DC Field | Value | Language |
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dc.contributor.author | Albert, Christian | - |
dc.contributor.author | Albert, Annemarie | - |
dc.contributor.author | Kube, Johanna | - |
dc.contributor.author | Bellomo, Rinaldo | - |
dc.contributor.author | Wettersten, Nicholas | - |
dc.contributor.author | Kuppe, Hermann | - |
dc.contributor.author | Westphal, Sabine | - |
dc.contributor.author | Haase, Michael | - |
dc.contributor.author | Haase-Fielitz, Anja | - |
dc.date | 2017 | - |
dc.date.accessioned | 2018-04-11T01:10:43Z | - |
dc.date.available | 2018-04-11T01:10:43Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | The Journal of thoracic and cardiovascular surgery 2018; 155(6): 2441-2452.e13 | - |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/17406 | - |
dc.description.abstract | This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery-asoociated acute kidney injury (AKI) identified by standard criteria and/or urinary kidney biomarkers. Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI. Primary end point was acute renal replacement therapy or in-hospital mortality. Long-term end points among others included 5-year mortality. Patients with single-biomarker-positive subclinical AKI (RIFLE negative) were identified. We controlled for systemic inflammation using C-reactive protein test. Urinary biomarkers (neutrophil gelatinase-associated lipocalin, midkine, and interleukin 6) were identified as independent predictors of the primary end point. Neutrophil gelatinase-associated lipocalin, midkine, or interleukin 6 positivity or de novo/worsening proteinuria identified 21.1%, 16.9%, 30.5%, and 48.0% more cases, respectively, with likely subclinical AKI (biomarker positive/RIFLE negative) additionally to cases with RIFLE positivity alone. Patients with likely subclinical AKI (neutrophil gelatinase-associated lipocalin or interleukin 6 positive) had increased risk of primary end point (adjusted hazard ratio, 7.18; 95% confidence interval, 1.52-33.93 [P = .013] and hazard ratio, 6.27; 95% confidence interval, 1.12-35.21 [P = .037]), respectively. Compared with biomarker-negative/RIFLE-positive patients, neutrophil gelatinase-associated lipocalin positive/RIFLE-positive or midkine-positive/RIFLE-positive patients had increased risk of primary end point (odds ratio, 9.6; 95% confidence interval, 1.4-67.3 [P = .033] and odds ratio, 14.7; 95% confidence interval, 2.0-109.2 [P = .011], respectively). Three percent to 11% of patients appear to be influenced by single-biomarker-positive subclinical AKI. During follow-up, kidney biomarker-defined short-term outcomes appeared to translate into long-term outcomes. Urinary kidney biomarkers identified RIFLE-negative patients with high-risk subclinical AKI as well as a higher risk subgroup of patients among RIFLE-AKI-positive patients. These findings support the concept that urinary biomarkers define subclinical AKI and higher risk subpopulations with worse long-term prognosis among standard patients with AKI. | - |
dc.language.iso | eng | - |
dc.subject | acute kidney injury | - |
dc.subject | cardiac surgery | - |
dc.subject | interleukin-6 | - |
dc.subject | midkine | - |
dc.subject | neutrophil gelatinase-associated lipocalin | - |
dc.subject | subclinical AKI | - |
dc.title | Urinary biomarkers may provide prognostic information for subclinical acute kidney injury after cardiac surgery. | - |
dc.type | Journal Article | - |
dc.identifier.journaltitle | The Journal of thoracic and cardiovascular surgery | - |
dc.identifier.affiliation | Clinic of Nephrology and Hypertension, Diabetes and Endocrinology, Otto-von-Guericke University, Magdeburg, Germany | en |
dc.identifier.affiliation | Medical Faculty Otto-von-Guericke University, Magdeburg, Germany | - |
dc.identifier.affiliation | Diaverum Deutschland, Potsdam, Germany | en |
dc.identifier.affiliation | Department of Intensive Care, German Heart Center Leipzig, University Clinic, Leipzig, Germany | - |
dc.identifier.affiliation | Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia | - |
dc.identifier.affiliation | Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, Calif | - |
dc.identifier.affiliation | Department of Anesthesiology, The German Heart Center, Berlin, Germany | - |
dc.identifier.affiliation | Institute of Laboratory Medicine, Hospital Dessau, Dessau, Germany | - |
dc.identifier.affiliation | Brandenburg Medical School (MHB) and Heart Center Brandenburg, Department of Cardiology, Bernau, Germany | - |
dc.identifier.affiliation | Institute of Social Medicine and Health Economics, Otto-von-Guericke University, Magdeburg, Germany | - |
dc.identifier.doi | 10.1016/j.jtcvs.2017.12.056 | - |
dc.identifier.orcid | 0000-0002-1650-8939 | - |
dc.identifier.pubmedid | 29366580 | - |
dc.type.austin | Journal Article | - |
local.name.researcher | Bellomo, Rinaldo | |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.openairetype | Journal Article | - |
item.grantfulltext | none | - |
item.cerifentitytype | Publications | - |
item.fulltext | No Fulltext | - |
item.languageiso639-1 | en | - |
crisitem.author.dept | Intensive Care | - |
crisitem.author.dept | Data Analytics Research and Evaluation (DARE) Centre | - |
Appears in Collections: | Journal articles |
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