Acute Kidney Injury, Heart Failure, and Health Outcomes

Gudsoorkar, Prakash; Thakar, Charuhas V.

doi:10.1016/j.ccl.2019.04.005

Cited by 18 publications

(23 citation statements)

References 45 publications

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“…Therefore, one challenge for improving the clinical outcomes of patients with ADHF is investigation of novel biomarkers to accurately predict the occurrence of AKI in patients with ADHF. 3 Serum creatinine levels are an established biomarker for diagnosing AKI from patients with ADHF, but its clinical use is limited by its delayed results. 20 NGAL has recently been used as a classic biomarker of AKI, which is closely related to renal function.…”

Section: Discussionmentioning

confidence: 99%

“…2 Therefore, early prediction of occurrence of AKI is important for decisions on clinical management and improving clinical outcomes in patients with ADHF. 3 Currently, the diagnosis of AKI mainly relies on some indicators of renal function, such as urine output and serum creatinine levels, but they show limited sensitivity and delayed results. 4 Neutrophil gelatinase-associated lipocalin (NGAL) has been recently used as an early diagnostic biomarker of AKI, but its diagnostic accuracy is not ideal.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic and prognostic significance of aberrant miR-652-3p levels in patients with acute decompensated heart failure and acute kidney injury

Liu

Zhang

et al. 2020

J Int Med Res

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Objective This study aimed to examine a novel microRNA (miR-652-3p) biomarker to improve early diagnosis of acute kidney injury (AKI) in patients with acute decompensated heart failure (ADHF) and to evaluate the survival predictive value of miR-652-3p. Methods We retrospectively analyzed the data of 196 patients with ADHF, including 65 who developed AKI during hospitalization. Neutrophil gelatinase-associated lipocalin (NGAL) levels were measured in serum and urine samples. Real-time quantitative PCR was applied to evaluate miR-652-3p mRNA expression. The diagnostic performance of miR-652-3p was examined using receiver operating characteristic curve analysis. The prognostic value of miR-652-3p was also analyzed. Results Serum and urinary NGAL and miR-652-3p levels were elevated in patients with ADHF and AKI. Serum and urinary miR-652-3p expression had diagnostic value in predicting AKI onset in patients with ADHF, and it had improved diagnostic performance when used with NGAL. Patients with AKI and high miR-652-3p levels had a high failure rate of renal recovery and poor 180-day survival. Conclusion Serum and urinary miR-652-3p may be a candidate biomarker for early diagnosis of AKI in patients with ADHF and for predicting the prognosis of AKI. The combination of NGAL and miR-652-3p may accurately predict AKI onset in ADHF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic and prognostic significance of aberrant miR-652-3p levels in patients with acute decompensated heart failure and acute kidney injury

Liu

Zhang

et al. 2020

J Int Med Res

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“…However, in contrast to our study, this was not considered as a prognostic factor in EHFS II. 15 Some studies 16 have demonstrated that patients with ADCHF who received extracorporeal ultrafiltration had poor survival outcomes. It was thought that this finding might be due to diuretic resistance.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies 16 have demonstrated that patients with ADCHF who received extracorporeal ultrafiltration had poor survival outcomes. It was thought that this finding might be due to diuretic resistance.…”

Section: Discussionmentioning

confidence: 99%

A New Risk Score to Predict In-Hospital Mortality in Elderly Patients With Acute Heart Failure: On Behalf of the Journey HF-TR Study Investigators

et al. 2020

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We aimed to predict in-hospital mortality of elderly patients with heart failure (HF) by using a risk score model which could be easily applied in routine clinical practice without using an electronic calculator. The study population (n = 1034) recruited from the Journey HF-TR (Patient Journey in Hospital with Heart Failure in Turkish Population) study was divided into a derivation and a validation cohort. The parameters related to in-hospital mortality were first analyzed by univariate analysis, then the variables found to be significant in that analysis were entered into a stepwise multivariate logistic regression (LR) analysis. Patients were classified as low, intermediate, and high risk. A risk score obtained by taking into account the regression coefficients of the significant variables as a result of the LR analysis was tested in the validation cohort using receiver operating characteristic curve analysis. In total, 6 independent variables (age, blood urea nitrogen, previous history of hemodialysis/hemofiltration, inotropic agent use, and length of intensive care stay) associated with in-hospital mortality were included in the analysis. The risk score had a good discrimination in both the derivation and validation cohorts. A new validated risk score to determine the risk of in-hospital mortality of elderly hospitalized patients with HF was developed by including 6 independent predictors.

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“…ADHF is considered a sudden worsening of the signs and symptoms of heart failure, which is one of the leading causes of hospitalization 1 . According to statistics, >30% of ADHF patients suffer from AKI during their hospitalization 2 . The coexistence of acute cardiac and renal dysfunction is called acute cardiorenal syndrome, which represents a serious clinical state with remarkably high incidence and mortality rates.…”

Section: Introductionmentioning

confidence: 99%

MicroRNA‐423‐5p as a biomarker for early diagnosis and outcome prediction of acute kidney injury in patients with acute decompensated heart failure

Zhang

Liu

et al. 2020

Int J of Urology

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ObjectiveTo evaluate the clinical significance of serum and urinary microRNA‐423‐5p in the prediction of acute kidney injury onset and survival in patients with acute decompensated heart failure.MethodsA total of 180 acute decompensated heart failure patients, including 57 acute kidney injury cases and 123 non‐acute kidney injury cases, were included in this study. Serum and urinary neutrophil gelatinase‐associated lipocalin, a biomarker of renal injury of acute kidney injury, was detected using an enzyme‐linked immunosorbent assay. Expression of microRNA‐423‐5p in serum and urine samples was examined using quantitative real‐time polymerase chain reaction. The clinical significance of microRNA‐423‐5p was evaluated using receiver operating characteristic curve and Kaplan–Meier survival analysis.ResultsThe levels of neutrophil gelatinase‐associated lipocalin and microRNA‐423‐5p in serum and urine samples were elevated in patients with acute kidney injury compared with the non‐acute kidney injury cases (all P < 0.05). Serum and urinary microRNA‐423‐5p had relatively high predictive performance for acute kidney injury onset in acute decompensated heart failure patients, and this predictive value was more significant when combined with urinary neutrophil gelatinase‐associated lipocalin. In addition, serum and urinary elevated levels of microRNA‐423‐5p predicted a poor 180‐day survival in the acute kidney injury group.ConclusionIncreased serum and urinary microRNA‐423‐5p can predict the occurrence of acute kidney injury in acute decompensated heart failure patients, and is associated with poor survival of acute kidney injury patients. In addition, the diagnostic value of urine neutrophil gelatinase‐associated lipocalin for the early screening of acute kidney injury from acute decompensated heart failure patients might be improved by considering the changes in urinary microRNA‐423‐5p.

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Acute Kidney Injury, Heart Failure, and Health Outcomes

Cited by 18 publications

References 45 publications

Diagnostic and prognostic significance of aberrant miR-652-3p levels in patients with acute decompensated heart failure and acute kidney injury

Diagnostic and prognostic significance of aberrant miR-652-3p levels in patients with acute decompensated heart failure and acute kidney injury

A New Risk Score to Predict In-Hospital Mortality in Elderly Patients With Acute Heart Failure: On Behalf of the Journey HF-TR Study Investigators

MicroRNA‐423‐5p as a biomarker for early diagnosis and outcome prediction of acute kidney injury in patients with acute decompensated heart failure

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