Advanced

Heparin-binding protein as a biomarker of acute kidney injury in critical illness

Tydén, Jonas; Herwald, H. LU ; Hultin, M.; Walldén, J. and Johansson, J. (2017) In Acta Anaesthesiologica Scandinavica 61(7). p.797-803
Abstract

Background: There is no biomarker with high sensitivity and specificity for the development of acute kidney injury (AKI) in a mixed intensive care unit (ICU) population. Heparin-binding protein (HBP) is released from granulocytes and causes increased vascular permeability which plays a role in the development of AKI in sepsis and ischemia. The aim of this study was to investigate whether plasma levels of HBP on admission can predict the development of AKI in a mixed ICU population and in the subgroup with sepsis. Methods: Longitudinal observational study with plasma HBP levels from 245 patients taken on admission to ICU. Presence and severity of AKI was scored daily for 1 week. Results: Mean (95% CI) plasma concentrations of log HBP... (More)

Background: There is no biomarker with high sensitivity and specificity for the development of acute kidney injury (AKI) in a mixed intensive care unit (ICU) population. Heparin-binding protein (HBP) is released from granulocytes and causes increased vascular permeability which plays a role in the development of AKI in sepsis and ischemia. The aim of this study was to investigate whether plasma levels of HBP on admission can predict the development of AKI in a mixed ICU population and in the subgroup with sepsis. Methods: Longitudinal observational study with plasma HBP levels from 245 patients taken on admission to ICU. Presence and severity of AKI was scored daily for 1 week. Results: Mean (95% CI) plasma concentrations of log HBP (ng/ml) in the groups developing different stages of AKI were: stage 0 (n = 175), 3.5 (3.4–3.7); stage 1 (n = 33), 3.7 (3.5–4.0), stage 2 (n = 20), 4.4 (3.5–4.8); and stage 3 (n = 17), 4.6 (3.8–5.2). HBP levels were significantly higher in patients developing AKI stage 3 (P < 0.01) compared to AKI stage 0 and 1. The area under the curve (AUC) for HBP to discriminate the group developing AKI stage 2–3 was 0.70 (CI: 0.58–0.82) and in the subgroup with severe sepsis 0.88 (CI: 0.77–0.99). Conclusion: Heparin-binding protein levels on admission to ICU are associated with the development of severe kidney injury. The relationship between HBP and AKI needs to be further validated in larger studies.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
61
issue
7
pages
7 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85021778493
  • wos:000404981100012
ISSN
0001-5172
DOI
10.1111/aas.12913
language
English
LU publication?
yes
id
87558198-11b4-4316-b8b7-ecf8466a58b7
date added to LUP
2017-07-26 11:54:30
date last changed
2017-09-18 11:39:43
@article{87558198-11b4-4316-b8b7-ecf8466a58b7,
  abstract     = {<p>Background: There is no biomarker with high sensitivity and specificity for the development of acute kidney injury (AKI) in a mixed intensive care unit (ICU) population. Heparin-binding protein (HBP) is released from granulocytes and causes increased vascular permeability which plays a role in the development of AKI in sepsis and ischemia. The aim of this study was to investigate whether plasma levels of HBP on admission can predict the development of AKI in a mixed ICU population and in the subgroup with sepsis. Methods: Longitudinal observational study with plasma HBP levels from 245 patients taken on admission to ICU. Presence and severity of AKI was scored daily for 1 week. Results: Mean (95% CI) plasma concentrations of log HBP (ng/ml) in the groups developing different stages of AKI were: stage 0 (n = 175), 3.5 (3.4–3.7); stage 1 (n = 33), 3.7 (3.5–4.0), stage 2 (n = 20), 4.4 (3.5–4.8); and stage 3 (n = 17), 4.6 (3.8–5.2). HBP levels were significantly higher in patients developing AKI stage 3 (P &lt; 0.01) compared to AKI stage 0 and 1. The area under the curve (AUC) for HBP to discriminate the group developing AKI stage 2–3 was 0.70 (CI: 0.58–0.82) and in the subgroup with severe sepsis 0.88 (CI: 0.77–0.99). Conclusion: Heparin-binding protein levels on admission to ICU are associated with the development of severe kidney injury. The relationship between HBP and AKI needs to be further validated in larger studies.</p>},
  author       = {Tydén, Jonas and Herwald, H. and Hultin, M. and Walldén, J. and Johansson, J.},
  issn         = {0001-5172},
  language     = {eng},
  month        = {08},
  number       = {7},
  pages        = {797--803},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Heparin-binding protein as a biomarker of acute kidney injury in critical illness},
  url          = {http://dx.doi.org/10.1111/aas.12913},
  volume       = {61},
  year         = {2017},
}