Endothelial Damage Signals Refractory Acute Kidney Injury in Critically Ill Patients

Shock
Theis S Itenov“Procalcitonin And Survival Study” study group

Abstract

Critically ill patients with acute kidney injury (AKI) are heterogeneous on pathophysiology and prognosis. The role of endothelial damage in the pathogenesis of refractory AKI has not been clarified. The aim was to determine if biomarkers of endothelial damage, independently of the inflammatory insult on the kidney, can predict recovery of acute kidney injury. From the "Procalcitonin And Survival Study" multicenter intensive care unit cohort, followed for 28 days after admission, we included patients without chronic kidney disease, who survived >24 h after admission and with plasma samples at admission available for biomarker analysis. We defined AKI by the "Kidney Disease: Improving Global Outcomes" guidelines and recovery of prior kidney function as alive for five consecutive days after admission with no need for renal replacement therapy and creatinine levels consistently below ×1.5 the level before admission. We adjusted models for age, gender, vasopressor treatment, mechanical ventilation and levels of creatinine, procalcitonin, platelets, and bilirubin at admission. Of a total 213 with AKI at admission, 99 recovered prior kidney function during follow-up. Endothelial damage on admission, measured by Soluble Thrombomodulin...Continue Reading

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Citations

Sep 20, 2017·Journal of the American Society of Nephrology : JASN·Travis D HullKenneth Hoyt
Apr 25, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Caitlin M ForkerMichael G S Shashaty
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Jul 3, 2021·International Journal of Molecular Sciences·Wei-Chih KanChih-Chung Shiao

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