Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury

John R. Prowle; Antonio Artigas; Sean M. Bagshaw; Lui G. Forni; Michael Heung; Eric Hoste; Marlies Ostermann; Jay L. Koyner; Lakmir Chawla; J. Patrick Kampf; Thomas Kwan; Paul McPherson; John A. Kellum; K. Kashani; A. Al-Khafaji; T. Ardiles; A. Artigas; M. Bell; A. Bihorac; R. Birkhahn; C. M. Cely; L. S. Chawla; D. Davison; T. Feldkamp; M. N. Gong; K. J. Gunnerson; M. Haase; J. Hackett; P. Honore; E. A.J. Hoste; O. Joannes-Boyau; M. Joannidis; P. Kim; J. L. Koyner; D. T. Laskowitz; M. E. Lissauer; G. Marx; P. A. McCullough; S. Mullaney; M. Ostermann; T. Rimmele; N. I. Shapiro; A. D. Shaw; J. Shi; M. G. Walker; A. M. Sprague; J. L. Vincent; C. Vinsonneau; L. Wagner; R. G. Wilkerson; K. Zacharowski; J. A. Kellum; Azra Bihora; Ali Al-Khafaji; Luis M. Ortega; Ostermann Marlies; Michael Haase; Kai Zacharowski; Richard Wunderink; Kyle Gunnerson; Matthew Lissauer; Daniel Herr; Wesley H. Self; Patrick M. Honore; Danielle Davison; Michael Joannidis; Rebecca Schroeder; Sevag Demirjian; Luke Hodgson; Scott T. Wilber; Jennifer A. Frey; Ian Reilly; Jing Shi; J. Patrick Kampf; Lakhmir S. Chawla

doi:10.1097/CCE.0000000000000870

Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury

John R. Prowle, Antonio Artigas, Sean M. Bagshaw, Lui G. Forni, Michael Heung, Eric Hoste, Marlies Ostermann, Jay L. Koyner, Lakmir Chawla, J. Patrick Kampf, Thomas Kwan, Paul McPherson, John A. Kellum, K. Kashani, A. Al-Khafaji, T. Ardiles, A. Artigas, M. Bell, A. Bihorac, R. BirkhahnC. M. Cely, L. S. Chawla, D. Davison, T. Feldkamp, M. N. Gong, K. J. Gunnerson, M. Haase, J. Hackett, P. Honore, E. A.J. Hoste, O. Joannes-Boyau, M. Joannidis, P. Kim, J. L. Koyner, D. T. Laskowitz, M. E. Lissauer, G. Marx, P. A. McCullough, S. Mullaney, M. Ostermann, T. Rimmele, N. I. Shapiro, A. D. Shaw, J. Shi, M. G. Walker, A. M. Sprague, J. L. Vincent, C. Vinsonneau, L. Wagner, R. G. Wilkerson, K. Zacharowski, J. A. Kellum, Azra Bihora, Ali Al-Khafaji, Luis M. Ortega, Ostermann Marlies, Michael Haase, Kai Zacharowski, Richard Wunderink, Kyle Gunnerson, Matthew Lissauer, Daniel Herr, Wesley H. Self, Patrick M. Honore, Danielle Davison, Michael Joannidis, Rebecca Schroeder, Sevag Demirjian, Luke Hodgson, Scott T. Wilber, Jennifer A. Frey, Ian Reilly, Jing Shi, J. Patrick Kampf, Lakhmir S. Chawla

Medicine

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

Abstract

OBJECTIVES: To assess the added prognostic value of serial monitoring of urinary C-C motif chemokine ligand 14 (uCCL14) over that of single measurements, which have been shown to be prognostic for development of persistent severe acute kidney injury (AKI) in critically ill patients. DESIGN: Retrospective observational study. SETTING: Data derived from two multinational ICU studies (Ruby and Sapphire). PATIENTS: Critically ill patients with early stage 2-3 AKI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed three consecutive uCCL14 measurements at 12-hour intervals after diagnosis of stage 2-3 AKI by Kidney Disease Improving Global Outcomes criteria. Primary outcome was persistent severe AKI, defined as 72 consecutive hours of stage 3 AKI, death, or receipt of dialysis prior to 72 hours. uCCL14 was measured using the NEPHROCLEAR uCCL14 Test on the Astute 140 Meter (Astute Medical, San Diego, CA). Based on predefined, validated cutoffs, we categorized uCCL14 as: low (≤ 1.3 ng/mL), medium (> 1.3 to ≤ 13 ng/mL), or high (> 13 ng/mL). Seventy-five of 417 patients with three consecutive uCCL14 measurements developed persistent severe AKI. Initial uCCL14 category strongly correlated with primary endpoint and, in most cases (66%), uCCL14 category was unchanged over the first 24 hours. Compared with no change and accounting for baseline category, decrease in category was associated with decreased odds of persistent severe AKI (odds ratio [OR], 0.20; 95% CI, 0.08-0.45; p < 0.001) and an increase in category with increased odds (OR, 4.04; 95% CI, 1.75-9.46; p = 0.001). CONCLUSIONS: In one-third of patients with moderate to severe AKI uCCL14 risk category altered over three serial measurements and such changes were associated with altered risk for persistent severe AKI. Serial CCL-14 measurement may detect progression or resolution of underlying kidney pathology and help refine AKI prognosis.

Original language	English (US)
Pages (from-to)	E0870
Journal	Critical Care Explorations
Volume	5
Issue number	3
DOIs	https://doi.org/10.1097/CCE.0000000000000870
State	Published - Mar 1 2023

Keywords

C-C motif chemokine ligand 14
acute kidney injury
biomarkers
critical illness
prognosis

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

Access to Document

10.1097/CCE.0000000000000870

Cite this

Prowle, J. R., Artigas, A., Bagshaw, S. M., Forni, L. G., Heung, M., Hoste, E., Ostermann, M., Koyner, J. L., Chawla, L., Kampf, J. P., Kwan, T., McPherson, P., Kellum, J. A., Kashani, K., Al-Khafaji, A., Ardiles, T., Artigas, A., Bell, M., Bihorac, A., ... Chawla, L. S. (2023). Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury. Critical Care Explorations, 5(3), E0870. https://doi.org/10.1097/CCE.0000000000000870

Prowle, JR, Artigas, A, Bagshaw, SM, Forni, LG, Heung, M, Hoste, E, Ostermann, M, Koyner, JL, Chawla, L, Kampf, JP, Kwan, T, McPherson, P, Kellum, JA, Kashani, K, Al-Khafaji, A, Ardiles, T, Artigas, A, Bell, M, Bihorac, A, Birkhahn, R, Cely, CM, Chawla, LS, Davison, D, Feldkamp, T, Gong, MN, Gunnerson, KJ, Haase, M, Hackett, J, Honore, P, Hoste, EAJ, Joannes-Boyau, O, Joannidis, M, Kim, P, Koyner, JL, Laskowitz, DT, Lissauer, ME, Marx, G, McCullough, PA, Mullaney, S, Ostermann, M, Rimmele, T, Shapiro, NI, Shaw, AD, Shi, J, Walker, MG, Sprague, AM, Vincent, JL, Vinsonneau, C, Wagner, L, Wilkerson, RG, Zacharowski, K, Kellum, JA, Bihora, A, Al-Khafaji, A, Ortega, LM, Marlies, O, Haase, M, Zacharowski, K, Wunderink, R, Gunnerson, K, Lissauer, M, Herr, D, Self, WH, Honore, PM, Davison, D, Joannidis, M, Schroeder, R, Demirjian, S, Hodgson, L, Wilber, ST, Frey, JA, Reilly, I, Shi, J, Patrick Kampf, J & Chawla, LS 2023, 'Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury', Critical Care Explorations, vol. 5, no. 3, pp. E0870. https://doi.org/10.1097/CCE.0000000000000870

@article{95ee26bec6964bb181d7098d6b188b52,

title = "Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury",

abstract = "OBJECTIVES: To assess the added prognostic value of serial monitoring of urinary C-C motif chemokine ligand 14 (uCCL14) over that of single measurements, which have been shown to be prognostic for development of persistent severe acute kidney injury (AKI) in critically ill patients. DESIGN: Retrospective observational study. SETTING: Data derived from two multinational ICU studies (Ruby and Sapphire). PATIENTS: Critically ill patients with early stage 2-3 AKI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed three consecutive uCCL14 measurements at 12-hour intervals after diagnosis of stage 2-3 AKI by Kidney Disease Improving Global Outcomes criteria. Primary outcome was persistent severe AKI, defined as 72 consecutive hours of stage 3 AKI, death, or receipt of dialysis prior to 72 hours. uCCL14 was measured using the NEPHROCLEAR uCCL14 Test on the Astute 140 Meter (Astute Medical, San Diego, CA). Based on predefined, validated cutoffs, we categorized uCCL14 as: low (≤ 1.3 ng/mL), medium (> 1.3 to ≤ 13 ng/mL), or high (> 13 ng/mL). Seventy-five of 417 patients with three consecutive uCCL14 measurements developed persistent severe AKI. Initial uCCL14 category strongly correlated with primary endpoint and, in most cases (66%), uCCL14 category was unchanged over the first 24 hours. Compared with no change and accounting for baseline category, decrease in category was associated with decreased odds of persistent severe AKI (odds ratio [OR], 0.20; 95% CI, 0.08-0.45; p < 0.001) and an increase in category with increased odds (OR, 4.04; 95% CI, 1.75-9.46; p = 0.001). CONCLUSIONS: In one-third of patients with moderate to severe AKI uCCL14 risk category altered over three serial measurements and such changes were associated with altered risk for persistent severe AKI. Serial CCL-14 measurement may detect progression or resolution of underlying kidney pathology and help refine AKI prognosis.",

keywords = "C-C motif chemokine ligand 14, acute kidney injury, biomarkers, critical illness, prognosis",

author = "Prowle, {John R.} and Antonio Artigas and Bagshaw, {Sean M.} and Forni, {Lui G.} and Michael Heung and Eric Hoste and Marlies Ostermann and Koyner, {Jay L.} and Lakmir Chawla and Kampf, {J. Patrick} and Thomas Kwan and Paul McPherson and Kellum, {John A.} and K. Kashani and A. Al-Khafaji and T. Ardiles and A. Artigas and M. Bell and A. Bihorac and R. Birkhahn and Cely, {C. M.} and Chawla, {L. S.} and D. Davison and T. Feldkamp and Gong, {M. N.} and Gunnerson, {K. J.} and M. Haase and J. Hackett and P. Honore and Hoste, {E. A.J.} and O. Joannes-Boyau and M. Joannidis and P. Kim and Koyner, {J. L.} and Laskowitz, {D. T.} and Lissauer, {M. E.} and G. Marx and McCullough, {P. A.} and S. Mullaney and M. Ostermann and T. Rimmele and Shapiro, {N. I.} and Shaw, {A. D.} and J. Shi and Walker, {M. G.} and Sprague, {A. M.} and Vincent, {J. L.} and C. Vinsonneau and L. Wagner and Wilkerson, {R. G.} and K. Zacharowski and Kellum, {J. A.} and Azra Bihora and Ali Al-Khafaji and Ortega, {Luis M.} and Ostermann Marlies and Michael Haase and Kai Zacharowski and Richard Wunderink and Kyle Gunnerson and Matthew Lissauer and Daniel Herr and Self, {Wesley H.} and Honore, {Patrick M.} and Danielle Davison and Michael Joannidis and Rebecca Schroeder and Sevag Demirjian and Luke Hodgson and Wilber, {Scott T.} and Frey, {Jennifer A.} and Ian Reilly and Jing Shi and {Patrick Kampf}, J. and Chawla, {Lakhmir S.}",

year = "2023",

month = mar,

day = "1",

doi = "10.1097/CCE.0000000000000870",

language = "English (US)",

volume = "5",

pages = "E0870",

journal = "Critical Care Explorations",

issn = "2639-8028",

publisher = "Lippincott Williams and Wilkins",

number = "3",

}

TY - JOUR

T1 - Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury

AU - Prowle, John R.

AU - Artigas, Antonio

AU - Bagshaw, Sean M.

AU - Forni, Lui G.

AU - Heung, Michael

AU - Hoste, Eric

AU - Ostermann, Marlies

AU - Koyner, Jay L.

AU - Chawla, Lakmir

AU - Kampf, J. Patrick

AU - Kwan, Thomas

AU - McPherson, Paul

AU - Kellum, John A.

AU - Kashani, K.

AU - Al-Khafaji, A.

AU - Ardiles, T.

AU - Artigas, A.

AU - Bell, M.

AU - Bihorac, A.

AU - Birkhahn, R.

AU - Cely, C. M.

AU - Chawla, L. S.

AU - Davison, D.

AU - Feldkamp, T.

AU - Gong, M. N.

AU - Gunnerson, K. J.

AU - Haase, M.

AU - Hackett, J.

AU - Honore, P.

AU - Hoste, E. A.J.

AU - Joannes-Boyau, O.

AU - Joannidis, M.

AU - Kim, P.

AU - Koyner, J. L.

AU - Laskowitz, D. T.

AU - Lissauer, M. E.

AU - Marx, G.

AU - McCullough, P. A.

AU - Mullaney, S.

AU - Ostermann, M.

AU - Rimmele, T.

AU - Shapiro, N. I.

AU - Shaw, A. D.

AU - Shi, J.

AU - Walker, M. G.

AU - Sprague, A. M.

AU - Vincent, J. L.

AU - Vinsonneau, C.

AU - Wagner, L.

AU - Wilkerson, R. G.

AU - Zacharowski, K.

AU - Kellum, J. A.

AU - Bihora, Azra

AU - Al-Khafaji, Ali

AU - Ortega, Luis M.

AU - Marlies, Ostermann

AU - Haase, Michael

AU - Zacharowski, Kai

AU - Wunderink, Richard

AU - Gunnerson, Kyle

AU - Lissauer, Matthew

AU - Herr, Daniel

AU - Self, Wesley H.

AU - Honore, Patrick M.

AU - Davison, Danielle

AU - Joannidis, Michael

AU - Schroeder, Rebecca

AU - Demirjian, Sevag

AU - Hodgson, Luke

AU - Wilber, Scott T.

AU - Frey, Jennifer A.

AU - Reilly, Ian

AU - Shi, Jing

AU - Patrick Kampf, J.

AU - Chawla, Lakhmir S.

PY - 2023/3/1

Y1 - 2023/3/1

N2 - OBJECTIVES: To assess the added prognostic value of serial monitoring of urinary C-C motif chemokine ligand 14 (uCCL14) over that of single measurements, which have been shown to be prognostic for development of persistent severe acute kidney injury (AKI) in critically ill patients. DESIGN: Retrospective observational study. SETTING: Data derived from two multinational ICU studies (Ruby and Sapphire). PATIENTS: Critically ill patients with early stage 2-3 AKI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed three consecutive uCCL14 measurements at 12-hour intervals after diagnosis of stage 2-3 AKI by Kidney Disease Improving Global Outcomes criteria. Primary outcome was persistent severe AKI, defined as 72 consecutive hours of stage 3 AKI, death, or receipt of dialysis prior to 72 hours. uCCL14 was measured using the NEPHROCLEAR uCCL14 Test on the Astute 140 Meter (Astute Medical, San Diego, CA). Based on predefined, validated cutoffs, we categorized uCCL14 as: low (≤ 1.3 ng/mL), medium (> 1.3 to ≤ 13 ng/mL), or high (> 13 ng/mL). Seventy-five of 417 patients with three consecutive uCCL14 measurements developed persistent severe AKI. Initial uCCL14 category strongly correlated with primary endpoint and, in most cases (66%), uCCL14 category was unchanged over the first 24 hours. Compared with no change and accounting for baseline category, decrease in category was associated with decreased odds of persistent severe AKI (odds ratio [OR], 0.20; 95% CI, 0.08-0.45; p < 0.001) and an increase in category with increased odds (OR, 4.04; 95% CI, 1.75-9.46; p = 0.001). CONCLUSIONS: In one-third of patients with moderate to severe AKI uCCL14 risk category altered over three serial measurements and such changes were associated with altered risk for persistent severe AKI. Serial CCL-14 measurement may detect progression or resolution of underlying kidney pathology and help refine AKI prognosis.

AB - OBJECTIVES: To assess the added prognostic value of serial monitoring of urinary C-C motif chemokine ligand 14 (uCCL14) over that of single measurements, which have been shown to be prognostic for development of persistent severe acute kidney injury (AKI) in critically ill patients. DESIGN: Retrospective observational study. SETTING: Data derived from two multinational ICU studies (Ruby and Sapphire). PATIENTS: Critically ill patients with early stage 2-3 AKI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed three consecutive uCCL14 measurements at 12-hour intervals after diagnosis of stage 2-3 AKI by Kidney Disease Improving Global Outcomes criteria. Primary outcome was persistent severe AKI, defined as 72 consecutive hours of stage 3 AKI, death, or receipt of dialysis prior to 72 hours. uCCL14 was measured using the NEPHROCLEAR uCCL14 Test on the Astute 140 Meter (Astute Medical, San Diego, CA). Based on predefined, validated cutoffs, we categorized uCCL14 as: low (≤ 1.3 ng/mL), medium (> 1.3 to ≤ 13 ng/mL), or high (> 13 ng/mL). Seventy-five of 417 patients with three consecutive uCCL14 measurements developed persistent severe AKI. Initial uCCL14 category strongly correlated with primary endpoint and, in most cases (66%), uCCL14 category was unchanged over the first 24 hours. Compared with no change and accounting for baseline category, decrease in category was associated with decreased odds of persistent severe AKI (odds ratio [OR], 0.20; 95% CI, 0.08-0.45; p < 0.001) and an increase in category with increased odds (OR, 4.04; 95% CI, 1.75-9.46; p = 0.001). CONCLUSIONS: In one-third of patients with moderate to severe AKI uCCL14 risk category altered over three serial measurements and such changes were associated with altered risk for persistent severe AKI. Serial CCL-14 measurement may detect progression or resolution of underlying kidney pathology and help refine AKI prognosis.

KW - C-C motif chemokine ligand 14

KW - acute kidney injury

KW - biomarkers

KW - critical illness

KW - prognosis

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DO - 10.1097/CCE.0000000000000870

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JF - Critical Care Explorations

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ER -

Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury

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