@article{TEXTUAL,
      recid = {7037},
      author = {Coca, Steven G. and Nadkarni, Girish N. and Garg, Amit X.  and Koyner, Jay and Thiessen-Philbrook, Heather and  McArther, Eric and Shlipak, Michael G. and Parikh, Chirag  R. and TRIBE-AKI Consortium},
      title = {First Post-Operative Urinary Kidney Injury Biomarkers and  Association with the Duration of AKI in the TRIBE-AKI  Cohort},
      journal = {PLOS ONE},
      address = {2016-08-18},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Background: We previously demonstrated that assessment  of the duration of AKI, in addition to magnitude of rise in  creatinine alone, adds prognostic information for long-term  survival. We evaluated whether post-operative kidney injury  biomarkers in urine collected immediately after cardiac  surgery associate with duration of serum creatinine  elevation.&lt;/p&gt; &lt;p&gt;Methods: We studied 1199 adults  undergoing cardiac surgery in a prospective cohort study  (TRIBE-AKI) and examined the association between the levels  of five urinary biomarkers individually at 0–6 hours after  surgery: interleukin-18 (IL-18), neutrophil  gelatinase-associated lipocalin (NGAL), kidney injury  molecule-1 (KIM-1), liver fatty acid binding protein  (L-FABP) and albumin with duration of serum  creatinine-based AKIN criteria for AKI (0 (no AKI), 1–2,  3–6, ≥7 days).&lt;/p&gt; &lt;p&gt;Results: Overall, 407 (34%) patients  had at least stage 1 AKI, of whom 251 (61.7%) had duration  of 1–2 days, 118 (28.9%) had duration 3–6 days, and 38  (9.3%) had duration of ≥7 days. Higher concentrations of  all biomarkers (per log increase) were independently  associated with a greater odds of a longer duration of AKI;  odds ratios and 95% confidence intervals using ordinal  logistic regression were the following: IL-18: 1.22,  1.13–1.32; KIM-1: 1.36, 1.21–1.52; albumin 1.20, 1.09–1.32;  L-FABP 1.11, 1.04–1.19; NGAL 1.06, 1.00–1.14). AKI duration  of 7 days or longer was associated with a 5-fold adjusted  risk of mortality at 3 years.&lt;/p&gt; &lt;p&gt;Conclusions: There was  an independent dose-response association between urinary  levels of injury biomarkers immediately after cardiac  surgery and longer duration of AKI. Duration of AKI was  also associated with long term mortality. Future studies  should explore the potential utility of these urinary  kidney injury biomarkers to enrich enrollment of patients  at risk for longer duration of AKI into trials of  interventions to prevent or treat post-operative AKI.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/7037},
}