Kinetic XXXX and Novel AKI Biomarkers to Predict Renal Recovery.

@entity1 @entity1552 @entity8 @entity13645 @entity470 @entity1458 @entity1011 @entity15901 @entity204
BACKGROUND AND OBJECTIVES: Prompt recognition of severe @entity8 could improve the early management of critically ill @entity1 . We compared the value of kinetic @entity470 , plasma @entity15901 ( @entity15901 ), and urine tissue inhibitor of metalloproteinase-2 and urine insulin-like growth factor-binding protein 7 ([ @entity1552 ]*[ @entity13645 ]) in predicting short-term recovery from AKI and major adverse kidney events. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: During the 6-month study period, 245 @entity1 were admitted to our intensive care unit. This study included 57 consecutive @entity1 presenting with AKI within the first 24 hours after admission. AKI markers were evaluated at inclusion (day 0) and 24 hours later (day 1). Kinetic @entity470 was calculated on day 1 according to serum @entity1011 evolution. Renal recovery was defined as normalization of serum @entity1011 with reversal of @entity1458 within 48 hours. Major adverse kidney events included @entity204 , need for RRT, or persistence of @entity8 at hospital discharge. RESULTS: Plasma @entity15901 and [ @entity1552 ]*[ @entity13645 ] predicted renal recovery, with area under the receiver-operating characteristic curve (AUC-ROC) values between 0.70 and 0.79 at inclusion. Although plasma @entity15901 values frequently reached the maximal measurement range, their decrease on day 1 predicted recovery. The kinetic @entity470 calculation after initial resuscitation provided the best AUC-ROC value for renal recovery, at 0.87. The best predictions for major adverse kidney events were provided by [ @entity1552 ]*[ @entity13645 ] and kinetic @entity470 (equal AUC-ROCs of 0.81). Combining AKI markers in addition to clinical prediction models improved the discrimination and reclassification of @entity1 who will recover from AKI or suffer from major adverse kidney events. CONCLUSIONS: Biomarkers of @entity8 predicted short-term renal recovery and major adverse kidney events for an unselected cohort of critically ill @entity1 . Calculating the kinetic @entity470 imposed a delay after initial resuscitation but provided a good diagnostic and prognostic approach. The utility of functional and damage AKI marker combinations in addition to clinical information requires validation in larger prospective studies.
