Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest
Purpose. Acute kidney injury (AKI) is a common complication after out-of-hospital cardiac arrest (OHCA), leading to increased mortality and challenging prognostication. Our aim was to examine if urine biomarkers could early predict postarrest AKI and patient outcome. Methods. A prospective observati...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/4384796 |
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| author | Sigrid Beitland Espen Rostrup Nakstad Jens Petter Berg Anne-Marie Siebke Trøseid Berit Sletbakk Brusletto Cathrine Brunborg Christofer Lundqvist Kjetil Sunde |
| author_facet | Sigrid Beitland Espen Rostrup Nakstad Jens Petter Berg Anne-Marie Siebke Trøseid Berit Sletbakk Brusletto Cathrine Brunborg Christofer Lundqvist Kjetil Sunde |
| author_sort | Sigrid Beitland |
| collection | DOAJ |
| description | Purpose. Acute kidney injury (AKI) is a common complication after out-of-hospital cardiac arrest (OHCA), leading to increased mortality and challenging prognostication. Our aim was to examine if urine biomarkers could early predict postarrest AKI and patient outcome. Methods. A prospective observational study of resuscitated, comatose OHCA patients admitted to Oslo University Hospital in Norway. Urine samples were collected at admission and day three postarrest and analysed for β-2-microglobulin (β2M), osteopontin, and trefoil factor 3 (TFF3). Outcome variables were AKI within three days according to the Kidney Disease Improving Global Outcome criteria, in addition to six-month mortality and poor neurological outcome (PNO) (cerebral performance category 3–5). Results. Among 195 included patients (85% males, mean age 60 years), 88 (45%) developed AKI, 88 (45%) died, and 96 (49%) had PNO. In univariate analyses, increased urine β2M, osteopontin, and TFF3 levels sampled at admission and day three were independent risk factors for AKI, mortality, and PNO. Exceptions were that β2M measured at day three did not predict any of the outcomes, and TFF3 at admission did not predict AKI. In multivariate analyses, combining clinical parameters and biomarker levels, the area under the receiver operating characteristics curves (95% CI) were 0.729 (0.658–0.800), 0.797 (0.733–0.861), and 0.812 (CI 0.750–0.874) for AKI, mortality, and PNO, respectively. Conclusions. Urine levels of β2M, osteopontin, and TFF3 at admission and day three were associated with increased risk for AKI, mortality, and PNO in comatose OHCA patients. This trail is registered with NCT01239420. |
| format | Article |
| id | doaj-art-d92e04fb70904ecaae0be6c6536e6b20 |
| institution | OA Journals |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-d92e04fb70904ecaae0be6c6536e6b202025-08-20T02:20:58ZengWileyCritical Care Research and Practice2090-13052090-13132019-01-01201910.1155/2019/43847964384796Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac ArrestSigrid Beitland0Espen Rostrup Nakstad1Jens Petter Berg2Anne-Marie Siebke Trøseid3Berit Sletbakk Brusletto4Cathrine Brunborg5Christofer Lundqvist6Kjetil Sunde7Institute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, NorwayNorwegian National Unit for CBRNE Medicine, Oslo University Hospital, P.O.Box 4956 Nydalen, 0424 Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, NorwayDepartment of Medical Biochemistry, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, NorwayDepartment of Medical Biochemistry, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, NorwayOslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, P.O.Box 1122 Blindern, 0317 Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, NorwayPurpose. Acute kidney injury (AKI) is a common complication after out-of-hospital cardiac arrest (OHCA), leading to increased mortality and challenging prognostication. Our aim was to examine if urine biomarkers could early predict postarrest AKI and patient outcome. Methods. A prospective observational study of resuscitated, comatose OHCA patients admitted to Oslo University Hospital in Norway. Urine samples were collected at admission and day three postarrest and analysed for β-2-microglobulin (β2M), osteopontin, and trefoil factor 3 (TFF3). Outcome variables were AKI within three days according to the Kidney Disease Improving Global Outcome criteria, in addition to six-month mortality and poor neurological outcome (PNO) (cerebral performance category 3–5). Results. Among 195 included patients (85% males, mean age 60 years), 88 (45%) developed AKI, 88 (45%) died, and 96 (49%) had PNO. In univariate analyses, increased urine β2M, osteopontin, and TFF3 levels sampled at admission and day three were independent risk factors for AKI, mortality, and PNO. Exceptions were that β2M measured at day three did not predict any of the outcomes, and TFF3 at admission did not predict AKI. In multivariate analyses, combining clinical parameters and biomarker levels, the area under the receiver operating characteristics curves (95% CI) were 0.729 (0.658–0.800), 0.797 (0.733–0.861), and 0.812 (CI 0.750–0.874) for AKI, mortality, and PNO, respectively. Conclusions. Urine levels of β2M, osteopontin, and TFF3 at admission and day three were associated with increased risk for AKI, mortality, and PNO in comatose OHCA patients. This trail is registered with NCT01239420.http://dx.doi.org/10.1155/2019/4384796 |
| spellingShingle | Sigrid Beitland Espen Rostrup Nakstad Jens Petter Berg Anne-Marie Siebke Trøseid Berit Sletbakk Brusletto Cathrine Brunborg Christofer Lundqvist Kjetil Sunde Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest Critical Care Research and Practice |
| title | Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest |
| title_full | Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest |
| title_fullStr | Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest |
| title_full_unstemmed | Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest |
| title_short | Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest |
| title_sort | urine β 2 microglobulin osteopontin and trefoil factor 3 may early predict acute kidney injury and outcome after cardiac arrest |
| url | http://dx.doi.org/10.1155/2019/4384796 |
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