Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25792
Title: Predictive Value of Plasma NGAL:Hepcidin-25 for Major Adverse Kidney Events After Cardiac Surgery with Cardiopulmonary Bypass: A Pilot Study.
Austin Authors: Albert, Christian;Haase, Michael;Albert, Annemarie;Ernst, Martin;Kropf, Siegfried;Bellomo, Rinaldo ;Westphal, Sabine;Braun-Dullaeus, Rüdiger C;Haase-Fielitz, Anja;Elitok, Saban
Affiliation: Medical Faculty, University Clinic for Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
Diaverum Renal Services, MVZ Potsdam, Potsdam, Germany
Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
Department of Nephrology and Endocrinology, Klinikum Ernst von Bergmann, Potsdam, Germany
Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
Institute for Biometrics and Medical Informatics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
Intensive Care
Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
Institute of Laboratory Medicine, Hospital Dessau, Dessau, Germany
Medical Faculty, University Clinic for Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
Department of Cardiology, Immanuel Diakonie Bernau, Heart Center Brandenburg, Brandenburg Medical School Theodor Fontane, MHB, Germany
Institute of Social Medicine and Health Systems Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
Faculty of Health Sciences Brandenburg, Potsdam, Germany
Issue Date: 1-Jul-2021
Publication information: Annals of Laboratory Medicine 2021; 41(4): 357-365
Abstract: Neutrophil gelatinase-associated lipocalin (NGAL) and hepcidin-25 are involved in catalytic iron-related kidney injury after cardiac surgery with cardiopulmonary bypass. We explored the predictive value of plasma NGAL, plasma hepcidin-25, and the plasma NGAL:hepcidin-25 ratio for major adverse kidney events (MAKE) after cardiac surgery. We compared the predictive value of plasma NGAL, hepcidin-25, and plasma NGAL:hepcidin-25 with that of serum creatinine (Cr) and urinary output and protein for primary-endpoint MAKE (acute kidney injury [AKI] stages 2 and 3, persistent AKI >48 hours, acute dialysis, and in-hospital mortality) and secondary-endpoint AKI in 100 cardiac surgery patients at intensive care unit (ICU) admission. We performed ROC curve, logistic regression, and reclassification analyses. At ICU admission, plasma NGAL, plasma NGAL:hepcidin-25, plasma interleukin-6, and Cr predicted MAKE (area under the ROC curve [AUC]: 0.77, 0.79, 0.74, and 0.74, respectively) and AKI (0.73, 0.89, 0.70, and 0.69). For AKI prediction, plasma NGAL:hepcidin-25 had a higher discriminatory power than Cr (AUC difference 0.26 [95% CI 0.00-0.53]). Urinary output and protein, plasma lactate, C-reactive protein, creatine kinase myocardial band, and brain natriuretic peptide did not predict MAKE or AKI (AUC <0.70). Only plasma NGAL:hepcidin-25 correctly reclassified patients according to their MAKE and AKI status (category-free net reclassification improvement: 0.82 [95% CI 0.12-1.52], 1.03 [0.29-1.77]). After adjustment to the Cleveland risk score, plasma NGAL:hepcidin-25 ≥0.9 independently predicted MAKE (adjusted odds ratio 16.34 [95% CI 1.77-150.49], P=0.014). Plasma NGAL:hepcidin-25 is a promising marker for predicting postoperative MAKE.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25792
DOI: 10.3343/alm.2021.41.4.357
ORCID: 0000-0002-6956-9962
0000-0001-8212-7416
0000-0002-5611-1506
0000-0003-3401-6935
0000-0002-5197-3481
0000-0002-1650-8939
0000-0002-5846-3345
0000-0003-3888-6532
0000-0001-6881-2249
0000-0002-1195-6871
PubMed URL: 33536353
Type: Journal Article
Subjects: Acute kidney injury
Cardiac surgery
Cardiopulmonary bypass
Hepcidin
Major adverse kidney events
Neutrophil gelatinase-associated lipocalin
Serum creatinine
Appears in Collections:Journal articles

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