Haiqun Lin1, Rebecca Scherzer2, Heather Thiessen Philbrook3, Steven G Coca4, Francis Perry Wilson3,5, Amit X Garg6, Michael G Shlipak2, Chirag R Parikh3,5. 1. Department of Biostatistics, Yale University School of Medicine, Connecticut, 60 College Street, New Haven, CT 06520, USA. 2. Department of Medicine, University of California San Francisco & Veterans Affairs Medical Center, San Francisco, CA 94121, USA. 3. Division of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, USA. 4. Division of Nephrology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY 10029, USA. 5. Department of Internal Medicine, Veterans Affairs Medical Center, West Haven, CT 06516, USA. 6. Division of Nephrology, Department of Medicine & Department of Epidemiology & Biostatistics, University of Western Ontario, London, N6A 3K7, Canada.
Abstract
AIM: To investigate early postoperative biomarkers for risk discrimination of advanced acute kidney injury (AKI). MATERIALS & METHODS: Postoperative plasma biomarkers including NGAL, h-FABP, CK-MB, hsTNT, NT-proBNP, IL-6, IL-10 and VEGF were analyzed using group-based method among 426 patients with AKI after cardiac surgery. RESULTS: Six patient groups with distinct biomarker patterns were identified. Individual biomarker displayed significant difference across the groups. The groups showed better discrimination for advanced AKI than any single biomarker either with or without adjusting for clinical variables. Average concentration of a single biomarker within each group, mortality and risk of a secondary outcome all demonstrated an approximately U-shaped relationship with proportion of advanced AKI within each group. CONCLUSION: The group-based analysis revealed that the order of the patient groups with an increasing likelihood of advanced AKI had a nonlinear relationship with average concentration of an individual biomarker, mortality and risk of other outcomes.
AIM: To investigate early postoperative biomarkers for risk discrimination of advanced acute kidney injury (AKI). MATERIALS & METHODS: Postoperative plasma biomarkers including NGAL, h-FABP, CK-MB, hsTNT, NT-proBNP, IL-6, IL-10 and VEGF were analyzed using group-based method among 426 patients with AKI after cardiac surgery. RESULTS: Six patient groups with distinct biomarker patterns were identified. Individual biomarker displayed significant difference across the groups. The groups showed better discrimination for advanced AKI than any single biomarker either with or without adjusting for clinical variables. Average concentration of a single biomarker within each group, mortality and risk of a secondary outcome all demonstrated an approximately U-shaped relationship with proportion of advanced AKI within each group. CONCLUSION: The group-based analysis revealed that the order of the patient groups with an increasing likelihood of advanced AKI had a nonlinear relationship with average concentration of an individual biomarker, mortality and risk of other outcomes.
Entities:
Keywords:
advanced AKI; biomarkers of AKI; group-based analysis
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