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dc.contributor.authorNaruse, H
dc.contributor.authorIshii, J
dc.contributor.authorTakahashi, H
dc.contributor.authorKitagawa, F
dc.contributor.authorNishimura, H
dc.contributor.authorKawai, H
dc.contributor.authorMuramatsu, T
dc.contributor.authorHarada, M
dc.contributor.authorYamada, A
dc.contributor.authorMotoyama, S
dc.contributor.authorMatsui, S
dc.contributor.authorHayashi, M
dc.contributor.authorSarai, M
dc.contributor.authorWatanabe, E
dc.contributor.authorIzawa, H
dc.contributor.authorOzaki, Y
dc.date.accessioned2020-02-04T00:37:44Z
dc.date.available2020-02-04T00:37:44Z
dc.date.issued2018
dc.identifier.issn1364-8535
dc.identifier.doi10.1186/s13054-018-2120-z
dc.identifier.urihttp://hdl.handle.net/10072/391086
dc.description.abstractBackground: The early prediction of acute kidney injury (AKI) can facilitate timely intervention and prevent complications. We aimed to understand the predictive value of urinary liver-type fatty-acid binding protein (L-FABP) levels on admission to medical (non-surgical) cardiac intensive care units (CICUs) for AKI, both independently and in combination with serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Methods: We prospectively investigated the predictive value of L-FABP and NT-proBNP for AKI in a large, heterogeneous cohort of patients treated in medical CICUs. Baseline urinary L-FABP and serum NT-proBNP were measured on admission. AKI was diagnosed according to the Kidney Disease: Improving Global Outcomes criteria. We studied 1273 patients (mean age, 68years), among whom 46% had acute coronary syndromes, 38% had acute decompensated heart failure, 5% had arrhythmia, 3% had pulmonary hypertension, 2% had acute aortic syndrome, 2% had infective endocarditis, and 1% had Takotsubo cardiomyopathy. Results: Urinary L-FABP levels correlated with serum NT-proBNP levels (r=0.17, p<0.0001). AKI occurred in 224 patients (17.6%), including 48 patients with stage 2 or 3 disease. Patients who developed AKI had higher one-week and 6-month mortality than those who did not develop AKI (p=0.0002 and p=0.003, respectively). In the multivariate logistic analysis, both L-FABP (p<0.0001) and NT-proBNP (p=0.006) were independently associated with the development of AKI. Adding L-FABP and NT-proBNP to a baseline model that included established risk factors further improved reclassification (p<0.001) and discrimination (p<0.01) beyond that of the baseline model or any single biomarker individually. Conclusions: Urinary L-FABP and serum NT-proBNP levels on admission are independent predictors of AKI, and when used in combination, improve early prediction of AKI in patients hospitalized at medical CICUs.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBioMed Central
dc.publisher.placeUnited Kingdom
dc.relation.ispartofpagefrom197:1
dc.relation.ispartofpageto197:10
dc.relation.ispartofissue1
dc.relation.ispartofjournalCritical Care
dc.relation.ispartofvolume22
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode3202
dc.subject.keywordsAcute kidney injury
dc.subject.keywordsLiver-type fatty-acid binding protein
dc.subject.keywordsMedical cardiac intensive care units
dc.subject.keywordsN-terminal pro-B-type natriuretic peptide
dc.titlePredicting acute kidney injury using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac intensive care units
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationNaruse, H; Ishii, J; Takahashi, H; Kitagawa, F; Nishimura, H; Kawai, H; Muramatsu, T; Harada, M; Yamada, A; Motoyama, S; Matsui, S; Hayashi, M; Sarai, M; Watanabe, E; Izawa, H; Ozaki, Y, Predicting acute kidney injury using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac intensive care units, Critical Care, 2018, 22 (1), pp. 197:1-197:10
dcterms.dateAccepted2018-07-03
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2020-02-04T00:07:39Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
gro.hasfulltextFull Text
gro.griffith.authorYamada, Akira


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