Acute kidney injury risk in orthopaedic trauma patients pre and post surgery using a biomarker algorithm and clinical risk score

Abstract

Acute kidney injury (AKI) after major trauma is associated with increased mortality. The aim of this study was to assess if measurement of blood biomarkers in combination with clinical characteristics could be used to develop a tool to assist clinicians in identifying which orthopaedic trauma patients are at risk of AKI. This is a prospective study of 237 orthopaedic trauma patients who were consecutively scheduled for open reduction and internal fixation of their fracture between May 2012 and August 2013. Clinical characteristics were recorded, and 28 biomarkers were analysed in patient blood samples. Post operatively a combination of H-FABP, sTNFR1 and MK had the highest predictive ability to identify patients at risk of developing AKI (AUROC 0.885). Three clinical characteristics; age, dementia and hypertension were identified in the orthopaedic trauma patients as potential risks for the development of AKI. Combining biomarker data with clinical characteristics allowed us to develop a proactive AKI clinical tool, which grouped patients into four risk categories that were associated with a clinical management regime that impacted patient care, management, length of hospital stay, and efficient use of hospital resources.

Prediction of early acute kidney injury after trauma using prehospital systolic blood pressure and lactate levels: A prospective validation study

“…Several small studies have attempted to predict post-traumatic AKI by scoring clinical parameters and specifying the cut-off values for biomarkers. [18][19][20] Unfortunately, these studies are not generalizable, as they are limited to the injury site or use biomarkers that are not measured in routine examinations.…”

A novel algorithm for cardiovascular screening using conjunctival microcirculatory parameters and blood biomarkers

“…The limits of detection (LOD) for the biomarkers were as follows: IL-1α 0.19 pg/ml; IL-1β 0.26 pg/ml; IL-2 2.97 pg/ml; IL-4 2.12 pg/ml; IL-6 0.12 pg/ml; IL-8 0.36 pg/ml; IL-10 0.37 pg/ml, VEGF 3.24 pg/ml; EGF 1.04 pg/ml; TNF-α 0.59 pg/ml; IFNɣ 0.44 pg/ml; MCP-1 3.53 pg/ml; H-FABP < 2.94 ng/ml; adiponectin 0.18 µg/ml; folate 2.72 nmol/l; homocysteine 1.74 µmol/l; vitamin B 12 73.8 pmol/l; HDL-3 4 mg/dl; plasma ADMA < 0.938 µmol/L; plasma LRG-1 < 0.0047 µg/ml. Results below the LOD were inputted as 90% of the LOD 36 .…”

Panax Ginseng C.A.Mey. as Medicine: The Potential Use of Panax Ginseng C.A.Mey. as a Remedy for Kidney Protection from a Pharmacological Perspective

“…Future CKD should focus not only on the inherent cells but also on the electrolyte abnormalities, proteinuria, and anemia. Although creatinine levels, proteinuria, urea nitrogen, and physiological and biochemical parameters could reflect renal functions in part, these outcomes might not show a replaceable role in the progression of renal diseases ( Luo et al, 2019 ; Kurth et al, 2020 ). Therefore, evaluating the composite of renal outcomes in clinical trials is a future direction for researchers.…”