Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Plasma endostatin and its association with new-onset acute kidney injury in critical care

Koozi, Hazem LU ; Engström, Jonas LU orcid ; Larsson, Anders ; Spångfors, Martin LU orcid ; Friberg, Hans LU and Frigyesi, Attila LU (2025) In Journal of Intensive Care 13. p.1-11
Abstract
Background
Endostatin is a promising biomarker for predicting acute kidney injury (AKI) and mortality in the intensive care unit (ICU). We investigated plasma endostatin levels at ICU admission as predictors of new-onset AKI within 48 h after ICU admission, renal replacement therapy (RRT) within 7 days after ICU admission, and 30-day mortality.

Methods
A retrospective multicentre study was performed with admissions to four ICUs. Blood samples were prospectively obtained at ICU admission and retrospectively analysed. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria defined AKI. Endostatin at ICU admission was compared to and adjusted for creatinine, cystatin C, and the Simplified Acute Physiology Score 3... (More)
Background
Endostatin is a promising biomarker for predicting acute kidney injury (AKI) and mortality in the intensive care unit (ICU). We investigated plasma endostatin levels at ICU admission as predictors of new-onset AKI within 48 h after ICU admission, renal replacement therapy (RRT) within 7 days after ICU admission, and 30-day mortality.

Methods
A retrospective multicentre study was performed with admissions to four ICUs. Blood samples were prospectively obtained at ICU admission and retrospectively analysed. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria defined AKI. Endostatin at ICU admission was compared to and adjusted for creatinine, cystatin C, and the Simplified Acute Physiology Score 3 (SAPS-3). Regression models and mean areas under the receiver operating characteristic curves (AUCs) from repeated cross-validation were assessed.

Results
In total, 4732 admissions were included. Endostatin was associated with new-onset AKI (OR 1.7, 95% CI 1.5
1.9), new-onset stage 3 AKI (OR 1.4, 95% CI 1.2
1.6), and RRT (OR 1.2, 95% CI 1.05
1.4) independently of creatinine, cystatin C, and SAPS-3. Endostatin was superior to creatinine and cystatin C in predicting new-onset AKI (mean AUC 0.67 vs. 0.63, p < 0.001). Adding endostatin to creatinine improved the prediction of new-onset AKI and new-onset stage 3 AKI, but not the need for RRT. Endostatin was not associated with 30-day mortality after adjusting for the SAPS-3 score.

Conclusions
Endostatin at ICU admission is an independent predictor of new-onset AKI and may improve early AKI risk assessment in the ICU. However, its predictive value for RRT and 30-day mortality appears limited. External validation and studies on its clinical utility are warranted. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Intensive Care
volume
13
article number
48
pages
1 - 11
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105014945734
ISSN
2052-0492
DOI
10.1186/s40560-025-00820-z
language
English
LU publication?
yes
id
ecc67467-bbe2-43b5-a9dd-9a767acbe84f
date added to LUP
2025-09-02 09:12:49
date last changed
2025-11-17 04:01:20
@article{ecc67467-bbe2-43b5-a9dd-9a767acbe84f,
  abstract     = {{Background<br/>Endostatin is a promising biomarker for predicting acute kidney injury (AKI) and mortality in the intensive care unit (ICU). We investigated plasma endostatin levels at ICU admission as predictors of new-onset AKI within 48 h after ICU admission, renal replacement therapy (RRT) within 7 days after ICU admission, and 30-day mortality.<br/><br/>Methods<br/>A retrospective multicentre study was performed with admissions to four ICUs. Blood samples were prospectively obtained at ICU admission and retrospectively analysed. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria defined AKI. Endostatin at ICU admission was compared to and adjusted for creatinine, cystatin C, and the Simplified Acute Physiology Score 3 (SAPS-3). Regression models and mean areas under the receiver operating characteristic curves (AUCs) from repeated cross-validation were assessed.<br/><br/>Results<br/>In total, 4732 admissions were included. Endostatin was associated with new-onset AKI (OR 1.7, 95% CI 1.5<br/>1.9), new-onset stage 3 AKI (OR 1.4, 95% CI 1.2<br/>1.6), and RRT (OR 1.2, 95% CI 1.05<br/>1.4) independently of creatinine, cystatin C, and SAPS-3. Endostatin was superior to creatinine and cystatin C in predicting new-onset AKI (mean AUC 0.67 vs. 0.63, p &lt; 0.001). Adding endostatin to creatinine improved the prediction of new-onset AKI and new-onset stage 3 AKI, but not the need for RRT. Endostatin was not associated with 30-day mortality after adjusting for the SAPS-3 score.<br/><br/>Conclusions<br/>Endostatin at ICU admission is an independent predictor of new-onset AKI and may improve early AKI risk assessment in the ICU. However, its predictive value for RRT and 30-day mortality appears limited. External validation and studies on its clinical utility are warranted.}},
  author       = {{Koozi, Hazem and Engström, Jonas and Larsson, Anders and Spångfors, Martin and Friberg, Hans and Frigyesi, Attila}},
  issn         = {{2052-0492}},
  language     = {{eng}},
  month        = {{09}},
  pages        = {{1--11}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Journal of Intensive Care}},
  title        = {{Plasma endostatin and its association with new-onset acute kidney injury in critical care}},
  url          = {{http://dx.doi.org/10.1186/s40560-025-00820-z}},
  doi          = {{10.1186/s40560-025-00820-z}},
  volume       = {{13}},
  year         = {{2025}},
}