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dc.contributor.authorProwle, John Ren
dc.contributor.authorOstland, Vaughnen
dc.contributor.authorCalzavacca, Paoloen
dc.contributor.authorLicari, Elisaen
dc.contributor.authorLigabo, E Valentinaen
dc.contributor.authorEcheverri, Jorge Een
dc.contributor.authorBagshaw, Sean Men
dc.contributor.authorHaase-Fielitz, Anjaen
dc.contributor.authorHaase, Michaelen
dc.contributor.authorWesterman, Marken
dc.contributor.authorBellomo, Rinaldoen
dc.identifier.citationNephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association 2011; 27(2): 595-602en
dc.description.abstractAcute kidney injury (AKI) is a common and serious complication of cardiopulmonary bypass (CPB) surgery. Hepcidin, a peptide hormone that regulates iron homeostasis, is a potential biomarker of AKI following CPB.We investigated the association between post-operative changes in serum and urinary hepcidin and AKI in 93 patients undergoing CPB.Twenty-five patients developed AKI based on the Risk, Injury, Failure, Loss, End-stage kidney disease (RIFLE) criteria in the first 5 days. Serum hepcidin, urine hepcidin concentration, the urinary hepcidin:creatinine ratio and fractional excretion of hepcidin in urine rose significantly after surgery. However, urine hepcidin concentration and urinary hepcidin:creatinine ratio were significantly lower at 24 h in patients with RIFLE-Risk, Injury or Failure compared to those without AKI (P = 0.0009 and P < 0.0001, respectively). Receiver operator characteristic analysis showed that lower 24-h urine hepcidin concentration and urinary hepcidin:creatinine ratio were sensitive and specific predictors of AKI. The urinary hepcidin:creatinine ratio had an area under the curve for the diagnosis of RIFLE ≥ risk at 24 h of 0.77 and of 0.84 for RIFLE ≥ injury. Urinary hepcidin had similar predictive accuracy. Such predictive ability remained when patients with early creatinine increases were excluded.Urinary hepcidin and hepcidin:creatinine ratio are biomarkers of AKI after CPB, with an inverse association between its increase at 24 h and risk of AKI in the first five post-operative days. Measuring hepcidin in the urine on the first day following surgery may deliver earlier diagnosis and interventions.en
dc.subject.otherAcute Kidney Injury.diagnosis.etiology.mortalityen
dc.subject.otherAntimicrobial Cationic Peptides.blood.urineen
dc.subject.otherArea Under Curveen
dc.subject.otherBiological Markers.blood.urineen
dc.subject.otherCohort Studiesen
dc.subject.otherCoronary Artery Bypass.adverse effects.methodsen
dc.subject.otherCoronary Stenosis.mortality.radiography.surgeryen
dc.subject.otherElective Surgical Procedures.adverse effects.methodsen
dc.subject.otherFollow-Up Studiesen
dc.subject.otherHospital Mortality.trendsen
dc.subject.otherMiddle Ageden
dc.subject.otherPostoperative Care.methodsen
dc.subject.otherPostoperative Complications.diagnosis.mortalityen
dc.subject.otherPredictive Value of Testsen
dc.subject.otherPreoperative Care.methodsen
dc.subject.otherROC Curveen
dc.subject.otherRisk Assessmenten
dc.subject.otherSensitivity and Specificityen
dc.subject.otherSurvival Rateen
dc.subject.otherTime Factorsen
dc.subject.otherTreatment Outcomeen
dc.titleGreater increase in urinary hepcidin predicts protection from acute kidney injury after cardiopulmonary bypass.en
dc.typeJournal Articleen
dc.identifier.journaltitleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Associationen
dc.identifier.affiliationDepartment of Intensive Care, Austin Hospital, Melbourne, Victoria, Australiaen
dc.type.austinJournal Articleen, Rinaldo
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.cerifentitytypePublications- Care- Analytics Research and Evaluation (DARE) Centre-
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