Please use this identifier to cite or link to this item: http://dx.doi.org/10.25673/101285
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dc.contributor.authorElitok, Saban-
dc.contributor.authorDevarajan, Prasad-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorIsermann, Berend-
dc.contributor.authorHaase, Michael-
dc.contributor.authorHaase-Fielitz, Anja-
dc.date.accessioned2023-03-06T13:18:42Z-
dc.date.available2023-03-06T13:18:42Z-
dc.date.issued2022-
dc.date.submitted2022-
dc.identifier.urihttps://opendata.uni-halle.de//handle/1981185920/103240-
dc.identifier.urihttp://dx.doi.org/10.25673/101285-
dc.description.abstractBackground Acute kidney injury (AKI) subtypes combining kidney functional parameters and injury biomarkers may have prognostic value. We aimed to determine whether neutrophil gelatinase-associated lipocalin (NGAL)/hepcidin-25 ratio (urinary concentrations of NGAL divided by that of hepcidin-25) defined subtypes are of prognostic relevance in cardiac surgery patients. Methods We studied 198 higher-risk cardiac surgery patients. We allocated patients to four groups: Kidney Disease Improving Global Outcomes (KDIGO)-AKI-negative and NGAL/hepcidin-25 ratio-negative (no AKI), KDIGO AKI-negative and NGAL/hepcidin-25 ratio-positive (subclinical AKI), KDIGO AKI-positive and NGAL/hepcidin-25 ratio-negative (clinical AKI), KDIGO AKI-positive and NGAL/hepcidin-25 ratio-positive (combined AKI). Outcomes included in-hospital mortality (primary) and long-term mortality (secondary). Results We identified 127 (61.6%) patients with no AKI, 13 (6.6%) with subclinical, 40 (20.2%) with clinical and 18 (9.1%) with combined AKI. Subclinical AKI patients had a 23-fold greater in-hospital mortality than no AKI patients. For combined AKI vs. no AKI or clinical AKI, findings were stronger (odds ratios (ORs): 126 and 39, respectively). After adjusting for EuroScore, volume of intraoperative packed red blood cells, and aortic cross-clamp time, subclinical and combined AKI remained associated with greater in-hospital mortality than no AKI and clinical AKI (adjusted ORs: 28.118, 95% CI 1.465–539.703; 3.737, 95% CI 1.746–7.998). Cox proportional hazard models found a significant association of biomarker-informed AKI subtypes with long-term survival compared with no AKI (adjusted ORs: pooled subclinical and clinical AKI: 1.885, 95% CI 1.003–3.542; combined AKI: 1.792, 95% CI 1.367–2.350). Conclusions In the presence or absence of KDIGO clinical criteria for AKI, the urinary NGAL/hepcidin-25-ratio appears to detect prognostically relevant AKI subtypes.eng
dc.description.sponsorshipProjekt DEAL 2021-
dc.language.isoeng-
dc.relation.ispartofhttps://www.springer.com/journal/40620-
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/-
dc.subjectCardiopulmonary bypasseng
dc.subjectCardiorenal syndromeeng
dc.subjectNGAL/hepcidin-25 ratioeng
dc.subjectSubclinical AKIeng
dc.subject.ddc610.72-
dc.titleNGAL/hepcidin-25 ratio and AKI subtypes in patients following cardiac surgery : a prospective observational studyeng
dc.typeArticle-
dc.identifier.urnurn:nbn:de:gbv:ma9:1-1981185920-1032406-
local.versionTypepublishedVersion-
local.bibliographicCitation.journaltitleJournal of nephrology-
local.bibliographicCitation.volume35-
local.bibliographicCitation.issue2-
local.bibliographicCitation.pagestart597-
local.bibliographicCitation.pageend605-
local.bibliographicCitation.publishernameSpringer-
local.bibliographicCitation.publisherplaceMilano-
local.bibliographicCitation.doi10.1007/s40620-021-01063-5-
local.openaccesstrue-
dc.identifier.ppn1817718401-
local.bibliographicCitation.year2022-
cbs.sru.importDate2023-03-06T13:14:57Z-
local.bibliographicCitationEnthalten in Journal of nephrology - Milano : Springer, 1996-
local.accessrights.dnbfree-
Appears in Collections:Medizinische Fakultät (OA)

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