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

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http://hdl.handle.net/10138/228549

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Tverring , J , Vaara , S T , Fisher , J , Poukkanen , M , Pettila , V , Linder , A & FINNAKI Study Grp 2017 , ' Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury ' , Annals of intensive care , vol. 7 , 105 . https://doi.org/10.1186/s13613-017-0330-1

Title: Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury
Author: Tverring, Jonas; Vaara, Suvi T.; Fisher, Jane; Poukkanen, Meri; Pettila, Ville; Linder, Adam; FINNAKI Study Grp
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
Date: 2017-10-18
Language: eng
Number of pages: 10
Belongs to series: Annals of intensive care
ISSN: 2110-5820
URI: http://hdl.handle.net/10138/228549
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 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.
Subject: Acute kidney injury
Sepsis
Biomarker
Heparin
binding protein
Risk model
CRITICALLY-ILL PATIENTS
ORGAN DYSFUNCTION
NEUTROPHILS
IDENTIFICATION
INFLAMMATION
MULTICENTER
SECRETION
MORTALITY
HBP/CAP37
FAILURE
3126 Surgery, anesthesiology, intensive care, radiology
3121 Internal medicine
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