Tubule dysfunction and injury and future risk of sepsis-associated acute kidney injury

被引:0
作者
Bullen, Alexander L. [1 ,2 ,8 ]
Katz, Ronit [3 ]
Garimella, Pranav S. [2 ]
Vaingankar, Sucheta [2 ]
Judd, Suzanne E. [4 ]
Rifkin, Dena E. [1 ,2 ]
Gutierrez, Orlando M. [5 ,6 ]
Wang, Henry [7 ]
Ix, Joachim H. [1 ,2 ]
机构
[1] Vet Affairs San Diego Healthcare Syst, Nephrol Sect, La Jolla, CA USA
[2] Univ Calif San Diego, Dept Med, Div Nephrol & Hypertens, San Diego, CA USA
[3] Univ Washington, Dept Obstet & Gynecol, Seattle, WA USA
[4] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA
[5] Univ Alabama Birmingham, Dept Med, Birmingham, AL USA
[6] Univ Alabama, Dept Epidemiol, Birmingham, OH USA
[7] Ohio State Univ, Wexner Med Ctr, Dept Emergency Med, Columbus, OH USA
[8] VA San Diego Healthcare Syst, Dept Med, Nephrol Sect, 3350 La Jolla Village Dr Mail Code 151A, San Diego, CA 92161 USA
关键词
acute kidney injury; sepsis; urine alpha-1 microglobulin (u alpha 1m); urine neutrophil gelatinase; associated lipocalin (uNGAL); ammonium; TAMM-HORSFALL PROTEIN; URINARY UROMODULIN; DISEASE; HEALTH; DEFINITIONS; MOLECULE-1; BIOMARKER; MORTALITY; AMMONIUM;
D O I
10.5414/CN111264
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Novel biomarkers can quantify both kidney tubule function, including proximal tubule reabsorptive (urine alpha-1 microglobulin (u alpha 1m)) and tubule protein synthesis capacities (urine uromodulin (uUMOD)), and tubular injury (urine neutrophil gelatinase-associated lipocalin (uNGAL)). In a blood pressure trial, we reported that lower reabsorptive and synthetic protein capacity at times of health predicted future risk of acute kidney injury (AKI), but most AKI was related to hemodynamic causes in this trial. Associations between tubular function and injury and future AKI related to other causes is unknown. Materials and methods: We performed a case-control study in REGARDS, a population-based cohort study, among participants who provided urine at the baseline visit. We matched each septic AKI case by age, sex, race, and time from baseline to hospital admission 1 : 1 to a participant with sepsis who did not develop AKI (controls). Using conditional logistic regression, we evaluated the associations of u alpha 1m, uUMOD, urine ammonium, and uNGAL with septic AKI. Results: Mean age was 69 +/- 8 years, 44% were female, and 39% were Black participants. Median base-line eGFR among cases and controls was 73 (55, 90) and 82 (65, 92) mL/min/1.73m(2), and median albuminuria was 19 (8, 87) vs. 9 (5, 22) mg/g, respectively. No independent associations were observed between the tubule function or injury markers and sub-sequent risk of septic AKI once models were adjusted for baseline albuminuria, estimated glomerular filtration rate, and other risk factors. Conclusion: Among community participants, tubule function and injury markers at times of health were not independently associated with future risk of septic AKI.
引用
收藏
页码:138 / 146
页数:9
相关论文
共 33 条
[1]   α1-Microglobulin:: a yellow-brown lipocalin [J].
Åkerström, B ;
Lögdberg, L ;
Berggård, T ;
Osmark, P ;
Lindqvist, A .
BIOCHIMICA ET BIOPHYSICA ACTA-PROTEIN STRUCTURE AND MOLECULAR ENZYMOLOGY, 2000, 1482 (1-2) :172-184
[2]   Association of Urinary Biomarkers of Kidney Injury with Estimated GFR Decline in HIV-Infected Individuals following Tenofovir Disoproxil Fumarate Initiation [J].
Ascher, Simon B. ;
Scherzer, Rebecca ;
Estrella, Michelle M. ;
Zhang, William R. ;
Muiru, Anthony N. ;
Jotwani, Vasantha ;
Grunfeld, Carl ;
Parikh, Chirag R. ;
Gustafson, Deborah ;
Young, Mary ;
Sharma, Anjali ;
Cohen, Mardge H. ;
Ng, Derek K. ;
Palella, Frank J. ;
Witt, Mallory D. ;
Ho, Ken ;
Shlipak, Michael G. .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2018, 13 (09) :1321-1329
[3]   Tamm-Horsfall protein knockout mice are more prone to urinary tract infection [J].
Bates, JM ;
Raffi, HM ;
Prasadan, K ;
Mascarenhas, R ;
Laszik, Z ;
Maeda, N ;
Hultgren, SJ ;
Kumar, S .
KIDNEY INTERNATIONAL, 2004, 65 (03) :791-797
[4]   Stony the road we trod: towards racial justice in kidney care [J].
Bignall, O. N. Ray, II ;
Crews, Deidra C. .
NATURE REVIEWS NEPHROLOGY, 2021, 17 (02) :79-80
[5]   The SPRINT trial suggests that markers of tubule cell function in the urine associate with risk of subsequent acute kidney injury while injury markers elevate after the injury [J].
Bullen, Alexander L. ;
Katz, Ronit ;
Lee, Alexandra K. ;
Anderson, Cheryl A. M. ;
Cheung, Alfred K. ;
Garimella, Pranav S. ;
Jotwani, Vasantha ;
Haley, William E. ;
Ishani, Areef ;
Lash, James P. ;
Neyra, Javier A. ;
Punzi, Henry ;
Rastogi, Anjay ;
Riessen, Erik ;
Malhotra, Rakesh ;
Parikh, Chirag R. ;
Rocco, Michael V. ;
Wall, Barry M. ;
Bhatt, Udayan Y. ;
Shlipak, Michael G. ;
Ix, Joachim H. ;
Estrella, Michelle M. .
KIDNEY INTERNATIONAL, 2019, 96 (02) :470-479
[6]   Urine Ammonium and Preclinical Acidosis in CKD [J].
DuBose, Thomas D., Jr. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2017, 28 (08) :2258-2260
[7]   Association of urinary uromodulin with kidney function decline and mortality: the health ABC study [J].
Garimella, Pranav S. ;
Katz, Ronit ;
Ix, Joachim H. ;
Fried, Linda F. ;
Kritchevsky, Stephen B. ;
Devarajan, Prasad ;
Bennett, Michael R. ;
Parikh, Chirag R. ;
Shlipak, Michael G. ;
Harris, Tamara B. ;
Gutierrez, Orlando M. ;
Sarnak, Mark J. .
CLINICAL NEPHROLOGY, 2017, 87 (06) :278-286
[8]   Urinary Uromodulin and Risk of Urinary Tract Infections: The Cardiovascular Health Study [J].
Garimella, Pranav S. ;
Bartz, Traci M. ;
Ix, Joachim H. ;
Chonchol, Michel ;
Shlipak, Michael G. ;
Devarajan, Prasad ;
Bennett, Michael R. ;
Sarnak, Mark J. .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2017, 69 (06) :744-751
[9]   Uromodulin in kidney health and disease [J].
Garimella, Pranav S. ;
Sarnak, Mark J. .
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 2017, 26 (02) :136-142
[10]   Urinary uromodulin, kidney function, and cardiovascular disease in elderly adults [J].
Garimella, Pranav S. ;
Biggs, Mary L. ;
Katz, Ronit ;
Ix, Joachim H. ;
Bennett, Michael R. ;
Devarajan, Prasad ;
Kestenbaum, Bryan R. ;
Siscovick, David S. ;
Jensen, Majken K. ;
Shlipak, Michael G. ;
Chaves, Paulo H. M. ;
Sarnak, Mark J. .
KIDNEY INTERNATIONAL, 2015, 88 (05) :1126-1134