Table 2.
Association of Log-transformed Continuous Early Post-operative Biomarkers with Any and Severe AKI and interaction with Pre-operative eGFR
| Urinary Biomarker | eGFR ≤ 60 ml/min/1.73m2 (n= 424) | eGFR > 60 ml/min/1.73m2 (n=795) | eGFR X Biomarker p-value | ||
|---|---|---|---|---|---|
| unadjusted RR (95% CI) | adjusted RR (95% CI) | unadjusted RR (95% CI) | adjusted RR (95% CI) | ||
| Association With Any AKI | |||||
| IL-18 | 1.08 [1.04, 1.12] | 1.04 [0.99, 1.09] | 1.14 [1.10, 1.17] | 1.11 [1.07, 1.15] | 0.007 |
| NGAL | 1.05 [1.01, 1.09] | 1.03 [0.99, 1.07] | 1.09 [1.06, 1.12] | 1.05 [1.02, 1.09] | 0.2 |
| KIM-1 | 1.14 [1.08, 1.21] | 1.09 [1.03, 1.16] | 1.16 [1.09, 1.23] | 1.16 [1.09, 1.23] | 0.3 |
| L-FABP | 1.04 [1.00, 1.08] | 1.02 [0.98, 1.06] | 1.09 [1.06, 1.12] | 1.06 [1.03, 1.10] | 0.06 |
| Cystatin C | 0.95 [0.87, 1.04] | 0.95 [0.87, 1.04] | 1.08 [0.97, 1.20] | 1.03 [0.95, 1.12] | 0.1 |
| Albumin | 1.09 [1.03, 1.15] | 1.06 [1.00, 1.13] | 1.12 [1.06, 1.18] | 1.09 [1.03, 1.16] | 0.5 |
| Association With Severe AKI | |||||
| IL-18 | 1.31 [1.16, 1.47] | 1.26 [1.11, 1.43] | 1.35 [1.23, 1.49] | 1.25 [1.11, 1.40] | 0.6 |
| NGAL | 1.22 [1.09, 1.37] | 1.18 [1.03, 1.35] | 1.20 [1.09, 1.33] | 1.09 [0.98, 1.22] | 0.8 |
| KIM-1 | 1.42 [1.13, 1.80] | 1.40 [1.05, 1.87] | 1.53 [1.29, 1.82] | 1.58 [1.28, 1.95] | 0.3 |
| L-FABP | 1.10 [0.94, 1.29] | 1.04 [0.90, 1.20] | 1.18 [1.04, 1.34] | 1.07 [0.96, 1.21] | 0.6 |
| Cystatin C | 1.40 [0.86, 2.26] | 1.36 [0.81, 2.28] | 1.01 [0.64, 1.58] | 0.88 [0.67, 1.15] | 0.2 |
| Albumin | 1.22 [0.98, 1.52] | 1.26 [0.85, 1.86] | 1.41 [1.18, 1.68] | 1.28 [1.04, 1.58] | 0.6 |
Note: Biomarkers were log2-transformed; RRs are expressed per doubling of biomarker concentration. Adjusted for age, gender, race, history of hypertension, history of diabetes, history of congestive heart failure, surgery status (elective vs. non-elective), type of surgery (bypass alone, valve alone or bypass and valve), myocardial infarction and cardiopulmonary bypass pump time.
AKI, acute kidney injury; CI, confidence interval; eGFR, estimated glomerular filtration rate; IL-18, interleukin 18; KIM-1, kidney injury molecule 1; L-FABP, liver-type fatty acid binding protein; NGAL, neutrophil gelatinase-associated lipocalin; RR. relative risk