Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury 英文参考文献.docVIP

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Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury 英文参考文献.doc

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Serum neutrophil gelatinase-associated lipocalin at inception of renal replacement therapy predicts survival in critically ill patients with acute kidney injury 英文参考文献

Kümpersetal.CriticalCare2010,14:R9 /content/14/1/R9 RESEARCH OpenAccess Serumneutrophilgelatinase-associatedlipocalin atinceptionofrenalreplacementtherapy predictssurvivalincriticallyillpatientswithacute kidneyinjury PhilippKümpers1,2*?,CarstenHafer1?,AlexanderLukasz1,RalfLichtinghagen3,KorbinianBrand3,DaniloFliser4, RobertFaulhaber-Walter1?,JanTKielstein1? Abstract Introduction:Neutrophilgelatinase-associatedlipocalin(NGAL)isapromisingnovelbiomarkerthatcorrelateswith theseverityandoutcomeofacutekidneyinjury(AKI).However,itsprognosticutilityduringthelatecourseofAKI, especiallyinpatientsthatrequirerenalreplacementtherapy(RRT)remainsunknown.Theaimofthisstudywasto evaluatethepredictivevalueofserumNGALinpatientswithestablishedAKIatinceptionofRRTintheintensive careunit(ICU). Methods:SerumNGAL(ELISAmethodology)wasmeasuredin109criticallyillpatientswithAKIatinceptionofRRT in7ICUsofatertiarycareuniversityhospital.Theprimaryoutcomestudiedwas28-daymortality.Secondary outcomemeasureswereICUlengthofstay,ventilator-freedays,andrenalrecoveryatday28. Results:TherewasasignificantdifferenceinserumNGALbetweenhealthysubjects(median[interquartilerange] 39.0[37.5-42.75]ng/mL),criticallyillpatientswithsystemicinflammatoryresponsesyndrome(SIRS)(297[184-490] ng/mL),andcriticallyillpatientswithsepsis(708[365-1301]ng/mL;P0.0001),respectively.Multiplelinear regressionshowedthatNGALlevelswereindependentlyrelatedtotheseverityofAKIandtheextentofsystemic inflammation.NGALlevelswerehigherinnon-survivors(430[303-942]ng/mL)comparedtosurvivors(298[159- 506]ng/mL;P=0.004).Consistently,CoxproportionalhazardsregressionanalysisidentifiedNGALasastrong independentpredictorfor28-daysurvival(hazardratio1.6(95%confidenceinterval[CI]1.15-2.23),P=0.005). Conclusions:ThisisthefirstprospectiveevaluationofserumNGALasanoutcome-specificbiomarkerincriticallyill patientsatinitiationofRRT.TheresultsfromthisstudyindicatethatserumNGALisasanindependentpredictorof 28-daymortalityinICUpatientswithdialysis-dependentAKI. Int