Kidney-specific biomarkers for predicting acute kidney injury following cardiac arrest

Noa Berlin; Rahul D. Pawar; Xiaowen Liu; Lakshman Balaji; Andrea C. Morton; Jeremy Silverman; Franklin Li; Mahmoud S. Issa; Lara L. Roessler; Mathias J. Holmberg; Aditya C. Shekhar; Michael W. Donnino; Ari Moskowitz; Anne V. Grossestreuer

doi:10.1016/j.resuscitation.2023.109911

Kidney-specific biomarkers for predicting acute kidney injury following cardiac arrest

Noa Berlin, Rahul D. Pawar, Xiaowen Liu, Lakshman Balaji, Andrea C. Morton, Jeremy Silverman, Franklin Li, Mahmoud S. Issa, Lara L. Roessler, Mathias J. Holmberg, Aditya C. Shekhar, Michael W. Donnino, Ari Moskowitz, Anne V. Grossestreuer

Research output: Contribution to journal › Article › peer-review

Abstract

Aim: To evaluate the performance of kidney-specific biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin-C) in early detection of acute kidney injury (AKI) following cardiac arrest (CA) when compared to serum creatinine. Methods: Adult CA patients who had kidney-specific biomarkers of AKI collected within 12 h of return of spontaneous circulation (ROSC) were included. The association between renal biomarker levels post-ROSC and the development of KDIGO stage III AKI within 7 days of enrollment were assessed as well as their predictive value of future AKI development, neurological outcomes, and survival to discharge. Results: Of 153 patients, 54 (35%) developed stage III AKI within 7 days, and 98 (64%) died prior to hospital discharge. Patients who developed stage III AKI, compared to those who did not, had higher median levels of creatinine, NGAL, and cystatin-C (p < 0.001 for all). There was no statistically significant difference in KIM-1 between groups. No biomarker outperformed creatinine in the ability to predict stage III AKI, neurological outcomes, or survival outcomes (p > 0.05 for all). However, NGAL, cystatin-C, and creatinine all performed better than KIM-1 in their ability to predict AKI development (p < 0.01 for all). Conclusion: In post-CA patients, creatinine, NGAL, and cystatin-C (but not KIM-1) measured shortly after ROSC were higher in patients who subsequently developed AKI. No biomarker was statistically superior to creatinine on its own for predicting the development of post-arrest AKI.

Original language	English (US)
Article number	109911
Journal	Resuscitation
Volume	190
DOIs	https://doi.org/10.1016/j.resuscitation.2023.109911
State	Published - Sep 2023
Externally published	Yes

Keywords

Creatinine
Cystatin-C
KIM-1
NGAL
Post-arrest
Renal biomarkers

ASJC Scopus subject areas

Emergency Medicine
Emergency
Cardiology and Cardiovascular Medicine

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10.1016/j.resuscitation.2023.109911

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Berlin, N., Pawar, R. D., Liu, X., Balaji, L., Morton, A. C., Silverman, J., Li, F., Issa, M. S., Roessler, L. L., Holmberg, M. J., Shekhar, A. C., Donnino, M. W., Moskowitz, A., & Grossestreuer, A. V. (2023). Kidney-specific biomarkers for predicting acute kidney injury following cardiac arrest. Resuscitation, 190, Article 109911. https://doi.org/10.1016/j.resuscitation.2023.109911

@article{4ae054a4693b41c88111afd767a387cf,

title = "Kidney-specific biomarkers for predicting acute kidney injury following cardiac arrest",

abstract = "Aim: To evaluate the performance of kidney-specific biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin-C) in early detection of acute kidney injury (AKI) following cardiac arrest (CA) when compared to serum creatinine. Methods: Adult CA patients who had kidney-specific biomarkers of AKI collected within 12 h of return of spontaneous circulation (ROSC) were included. The association between renal biomarker levels post-ROSC and the development of KDIGO stage III AKI within 7 days of enrollment were assessed as well as their predictive value of future AKI development, neurological outcomes, and survival to discharge. Results: Of 153 patients, 54 (35%) developed stage III AKI within 7 days, and 98 (64%) died prior to hospital discharge. Patients who developed stage III AKI, compared to those who did not, had higher median levels of creatinine, NGAL, and cystatin-C (p < 0.001 for all). There was no statistically significant difference in KIM-1 between groups. No biomarker outperformed creatinine in the ability to predict stage III AKI, neurological outcomes, or survival outcomes (p > 0.05 for all). However, NGAL, cystatin-C, and creatinine all performed better than KIM-1 in their ability to predict AKI development (p < 0.01 for all). Conclusion: In post-CA patients, creatinine, NGAL, and cystatin-C (but not KIM-1) measured shortly after ROSC were higher in patients who subsequently developed AKI. No biomarker was statistically superior to creatinine on its own for predicting the development of post-arrest AKI.",

keywords = "Creatinine, Cystatin-C, KIM-1, NGAL, Post-arrest, Renal biomarkers",

author = "Noa Berlin and Pawar, {Rahul D.} and Xiaowen Liu and Lakshman Balaji and Morton, {Andrea C.} and Jeremy Silverman and Franklin Li and Issa, {Mahmoud S.} and Roessler, {Lara L.} and Holmberg, {Mathias J.} and Shekhar, {Aditya C.} and Donnino, {Michael W.} and Ari Moskowitz and Grossestreuer, {Anne V.}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

year = "2023",

month = sep,

doi = "10.1016/j.resuscitation.2023.109911",

language = "English (US)",

volume = "190",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Kidney-specific biomarkers for predicting acute kidney injury following cardiac arrest

AU - Berlin, Noa

AU - Pawar, Rahul D.

AU - Liu, Xiaowen

AU - Balaji, Lakshman

AU - Morton, Andrea C.

AU - Silverman, Jeremy

AU - Li, Franklin

AU - Issa, Mahmoud S.

AU - Roessler, Lara L.

AU - Holmberg, Mathias J.

AU - Shekhar, Aditya C.

AU - Donnino, Michael W.

AU - Moskowitz, Ari

AU - Grossestreuer, Anne V.

PY - 2023/9

Y1 - 2023/9

N2 - Aim: To evaluate the performance of kidney-specific biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin-C) in early detection of acute kidney injury (AKI) following cardiac arrest (CA) when compared to serum creatinine. Methods: Adult CA patients who had kidney-specific biomarkers of AKI collected within 12 h of return of spontaneous circulation (ROSC) were included. The association between renal biomarker levels post-ROSC and the development of KDIGO stage III AKI within 7 days of enrollment were assessed as well as their predictive value of future AKI development, neurological outcomes, and survival to discharge. Results: Of 153 patients, 54 (35%) developed stage III AKI within 7 days, and 98 (64%) died prior to hospital discharge. Patients who developed stage III AKI, compared to those who did not, had higher median levels of creatinine, NGAL, and cystatin-C (p < 0.001 for all). There was no statistically significant difference in KIM-1 between groups. No biomarker outperformed creatinine in the ability to predict stage III AKI, neurological outcomes, or survival outcomes (p > 0.05 for all). However, NGAL, cystatin-C, and creatinine all performed better than KIM-1 in their ability to predict AKI development (p < 0.01 for all). Conclusion: In post-CA patients, creatinine, NGAL, and cystatin-C (but not KIM-1) measured shortly after ROSC were higher in patients who subsequently developed AKI. No biomarker was statistically superior to creatinine on its own for predicting the development of post-arrest AKI.

AB - Aim: To evaluate the performance of kidney-specific biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin-C) in early detection of acute kidney injury (AKI) following cardiac arrest (CA) when compared to serum creatinine. Methods: Adult CA patients who had kidney-specific biomarkers of AKI collected within 12 h of return of spontaneous circulation (ROSC) were included. The association between renal biomarker levels post-ROSC and the development of KDIGO stage III AKI within 7 days of enrollment were assessed as well as their predictive value of future AKI development, neurological outcomes, and survival to discharge. Results: Of 153 patients, 54 (35%) developed stage III AKI within 7 days, and 98 (64%) died prior to hospital discharge. Patients who developed stage III AKI, compared to those who did not, had higher median levels of creatinine, NGAL, and cystatin-C (p < 0.001 for all). There was no statistically significant difference in KIM-1 between groups. No biomarker outperformed creatinine in the ability to predict stage III AKI, neurological outcomes, or survival outcomes (p > 0.05 for all). However, NGAL, cystatin-C, and creatinine all performed better than KIM-1 in their ability to predict AKI development (p < 0.01 for all). Conclusion: In post-CA patients, creatinine, NGAL, and cystatin-C (but not KIM-1) measured shortly after ROSC were higher in patients who subsequently developed AKI. No biomarker was statistically superior to creatinine on its own for predicting the development of post-arrest AKI.

KW - Creatinine

KW - Cystatin-C

KW - KIM-1

KW - NGAL

KW - Post-arrest

KW - Renal biomarkers

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DO - 10.1016/j.resuscitation.2023.109911

M3 - Article

C2 - 37499974

AN - SCOPUS:85166633357

SN - 0300-9572

VL - 190

JO - Resuscitation

JF - Resuscitation

M1 - 109911

ER -

Kidney-specific biomarkers for predicting acute kidney injury following cardiac arrest

Abstract

Keywords

ASJC Scopus subject areas

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