Tags

Type your tag names separated by a space and hit enter

Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest.

Abstract

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.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Institute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, Norway. Department of Anaesthesiology, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway.

    ,

    Norwegian National Unit for CBRNE Medicine, Oslo University Hospital, P.O.Box 4956 Nydalen, 0424 Oslo, Norway.

    ,

    Institute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, Norway. Department of Medical Biochemistry, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway.

    ,

    Department of Medical Biochemistry, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway.

    ,

    Department of Medical Biochemistry, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway.

    ,

    Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, P.O.Box 1122 Blindern, 0317 Oslo, Norway.

    ,

    Institute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, Norway. Health Services Research Unit and Department of Neurology, Akershus University Hospital, P.O.Box 1000, 1478 Lørenskog, Norway.

    Institute of Clinical Medicine, University of Oslo, P.O.Box 1072 Blindern, 0316 Oslo, Norway. Department of Anaesthesiology, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31205786

    Citation

    Beitland, Sigrid, et al. "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, vol. 2019, 2019, p. 4384796.
    Beitland S, Nakstad ER, Berg JP, et al. Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest. Crit Care Res Pract. 2019;2019:4384796.
    Beitland, S., Nakstad, E. R., Berg, J. P., Trøseid, A. S., Brusletto, B. S., Brunborg, C., ... Sunde, K. (2019). 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, 2019, p. 4384796. doi:10.1155/2019/4384796.
    Beitland S, et al. Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome After Cardiac Arrest. Crit Care Res Pract. 2019;2019:4384796. PubMed PMID: 31205786.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest. AU - Beitland,Sigrid, AU - Nakstad,Espen Rostrup, AU - Berg,Jens Petter, AU - Trøseid,Anne-Marie Siebke, AU - Brusletto,Berit Sletbakk, AU - Brunborg,Cathrine, AU - Lundqvist,Christofer, AU - Sunde,Kjetil, Y1 - 2019/05/07/ PY - 2018/11/02/received PY - 2019/04/09/accepted PY - 2019/6/18/entrez PY - 2019/6/18/pubmed PY - 2019/6/18/medline SP - 4384796 EP - 4384796 JF - Critical care research and practice JO - Crit Care Res Pract VL - 2019 N2 - 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. SN - 2090-1305 UR - https://www.unboundmedicine.com/medline/citation/31205786/Urine_β-2-Microglobulin,_Osteopontin,_and_Trefoil_Factor_3_May_Early_Predict_Acute_Kidney_Injury_and_Outcome_after_Cardiac_Arrest L2 - https://dx.doi.org/10.1155/2019/4384796 DB - PRIME DP - Unbound Medicine ER -