C-terminal fragment of agrin CAF levels predict acute kidney injury after acute myocardial infarctionReportar como inadecuado




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BMC Nephrology

, 18:202

Clinical Research

Abstract

BackgroundPatients with acute myocardial infarction are at high risk for acute kidney injury. Novel biomarkers that can predict acute kidney injury in AMI may allow timely interventions. C-terminal fragment of agrin CAF, a proteoglycan of the glomerular and tubular basement membrane, have been recently associated with rapid renal function deterioration and proximal tubular dysfunction. It is unknown whether elevated CAF levels may serve as a novel AKI biomarker in patients presenting with AMI.

MethodsIn 436 persons enrolled in a multicenter prospective observational cohort study of patients with acute myocardial infarction, we measured plasma and urine levels of several kidney injury biomarkers including CAF, neutrophil gelatinase-associated lipocalin NGAL, interleukin-18 IL-18 and cystatin-C.The relationship between biomarker levels at baseline and the development of AKI and long-term mortality were analyzed after adjustment for demographic and clinical variables.

ResultsAKI incidence was up to 15% during hospitalization. The predictive accuracy for AKI of urinary CAF was similar to NGAL and superior to other tested kidney injury biomarkers. In a multivariate model that included all possible confounding variables only urinary CAF continued to be an independent marker for AKI OR 1.35 95%CI 1.05 -1.74. During the 2 years follow-up, only plasma CAF levels remained a significant independent predictor of mortality OR 2.5 95%CI 1.02-6.2; P = 0.04.

ConclusionsElevated CAF levels are associated with AKI in patients with acute myocardial infarction. Our study provides preliminary evidence that CAF levels may predict AKI and mortality after AMI in low risk patients with relative preserved kidney function at baseline.

KeywordsAcute kidney injury Acute myocardial infarction C-terminal agrin fragment Biomarkers AbbreviationsAKIAcute kidney injury

AMIAcute myocardial infarction

CAFc-terminal agrin fragment

Cyst-CCystatin C

IL-18Interleukin 18

KIM-1Kidney injury molecule-1

NGALNeutrophil gelatinase-associated lipocalin

Electronic supplementary materialThe online version of this article doi:10.1186-s12882-017-0611-9 contains supplementary material, which is available to authorized users.





Autor: Spyridon Arampatzis - Georgios Chalikias - Vasilios Devetzis - Stavros Konstantinides - Uyen Huynh-Do - Dimitrios Tziakas

Fuente: https://link.springer.com/







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