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Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury

Tverring, Jonas LU ; Vaara, Suvi T.; Fisher, Jane LU ; Poukkanen, Meri; Pettilä, Ville; Linder, Adam LU and , (2017) In Annals of Intensive Care 7(1).
Abstract

Background: Sepsis-related acute kidney injury (AKI) accounts for major morbidity and mortality among the critically ill. Heparin-binding protein (HBP) is a promising biomarker in predicting development and prognosis of severe sepsis and septic shock that has recently been proposed to be involved in the pathophysiology of AKI. The objective of this study was to investigate the added predictive value of measuring plasma HBP on admission to the intensive care unit (ICU) regarding the development of septic AKI. Methods: We included 601 patients with severe sepsis or septic shock from the prospective, observational FINNAKI study conducted in seventeen Finnish ICUs during a 5-month period (1 September 2011–1 February 2012). The main outcome... (More)

Background: Sepsis-related acute kidney injury (AKI) accounts for major morbidity and mortality among the critically ill. Heparin-binding protein (HBP) is a promising biomarker in predicting development and prognosis of severe sepsis and septic shock that has recently been proposed to be involved in the pathophysiology of AKI. The objective of this study was to investigate the added predictive value of measuring plasma HBP on admission to the intensive care unit (ICU) regarding the development of septic AKI. Methods: We included 601 patients with severe sepsis or septic shock from the prospective, observational FINNAKI study conducted in seventeen Finnish ICUs during a 5-month period (1 September 2011–1 February 2012). The main outcome measure was the development of KDIGO AKI stages 2–3 from 12 h after admission up to 5 days. Statistical analysis for the primary endpoint included construction of a clinical risk model, area under the receiver operating curve (ROC area), category-free net reclassification index (cfNRI) and integrated discrimination improvement (IDI) with 95% confidence intervals (95% CI). Results: Out of 511 eligible patients, 101 (20%) reached the primary endpoint. The addition of plasma HBP to a clinical risk model significantly increased ROC area (0.82 vs. 0.78, p = 0.03) and risk classification scores: cfNRI 62.0% (95% CI 40.5–82.4%) and IDI 0.053 (95% CI 0.029–0.075). Conclusions: Plasma HBP adds predictive value to known clinical risk factors in septic AKI. Further studies are warranted to compare the predictive performance of plasma HBP to other novel AKI biomarkers.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute kidney injury, Biomarker, Heparin-binding protein, Risk model, Sepsis
in
Annals of Intensive Care
volume
7
issue
1
publisher
Springer Open
external identifiers
  • scopus:85032036481
  • pmid:29047023
  • wos:000413721300001
ISSN
2110-5820
DOI
10.1186/s13613-017-0330-1
language
English
LU publication?
yes
id
66729b00-b82c-42f6-ba3f-8f693c41a1da
date added to LUP
2017-11-12 15:49:16
date last changed
2018-05-20 04:38:44
@article{66729b00-b82c-42f6-ba3f-8f693c41a1da,
  abstract     = {<p>Background: Sepsis-related acute kidney injury (AKI) accounts for major morbidity and mortality among the critically ill. Heparin-binding protein (HBP) is a promising biomarker in predicting development and prognosis of severe sepsis and septic shock that has recently been proposed to be involved in the pathophysiology of AKI. The objective of this study was to investigate the added predictive value of measuring plasma HBP on admission to the intensive care unit (ICU) regarding the development of septic AKI. Methods: We included 601 patients with severe sepsis or septic shock from the prospective, observational FINNAKI study conducted in seventeen Finnish ICUs during a 5-month period (1 September 2011–1 February 2012). The main outcome measure was the development of KDIGO AKI stages 2–3 from 12 h after admission up to 5 days. Statistical analysis for the primary endpoint included construction of a clinical risk model, area under the receiver operating curve (ROC area), category-free net reclassification index (cfNRI) and integrated discrimination improvement (IDI) with 95% confidence intervals (95% CI). Results: Out of 511 eligible patients, 101 (20%) reached the primary endpoint. The addition of plasma HBP to a clinical risk model significantly increased ROC area (0.82 vs. 0.78, p = 0.03) and risk classification scores: cfNRI 62.0% (95% CI 40.5–82.4%) and IDI 0.053 (95% CI 0.029–0.075). Conclusions: Plasma HBP adds predictive value to known clinical risk factors in septic AKI. Further studies are warranted to compare the predictive performance of plasma HBP to other novel AKI biomarkers.</p>},
  articleno    = {105},
  author       = {Tverring, Jonas and Vaara, Suvi T. and Fisher, Jane and Poukkanen, Meri and Pettilä, Ville and Linder, Adam and , },
  issn         = {2110-5820},
  keyword      = {Acute kidney injury,Biomarker,Heparin-binding protein,Risk model,Sepsis},
  language     = {eng},
  month        = {12},
  number       = {1},
  publisher    = {Springer Open},
  series       = {Annals of Intensive Care},
  title        = {Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury},
  url          = {http://dx.doi.org/10.1186/s13613-017-0330-1},
  volume       = {7},
  year         = {2017},
}