2015 Volume 6 Issue 2 Pages 124-128
Results of recent studies suggest that acute kidney injury (AKI) increases the risk of chronic kidney disease (CKD) development and progression, but what biomarker, if any, can predict CKD progression in AKI survivors remains unclear. This prospective observational study examined data of 495 adult patients admitted to the ICU of our hospital. We respectively evaluated long-term renal outcomes of halving of the estimated glomerular filtration rate and incident end-stage renal disease. Of the 495 patients, 169 were followed-up for three years after ICU discharge. Among them, 30 (17.8%) showed CKD progression. Three urinary biomarkers were measured at ICU admission: L-type fatty acid-binding protein (L-FABP), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl-β-D-glucosaminidase (NAG). Progressors showed significantly higher L-FABP and NGAL levels. Step-wise multiple logistic regression analysis revealed that only urinary L-FABP was associated significantly with CKD progression after ICU discharge. Receiver operating characteristic analysis showed the area under the curve of urinary L-FABP as 0.69 (95%CI 0.57-0.78). Results of this three-year follow-up study clarified that measurement of urinary L-FABP at ICU admission is useful for predicting long-term renal function after ICU discharge, and that high-risk populations should be monitored closely at outpatient clinics.
