Table 3.
Biomarkers for predicting AKI progression: multivariate logistic regression analyses
| Biomarker | Cut Points | N | AKI Progression (%) | Unadjusted OR (95% CI) | P Value | Adjusted ORa (95% CI) | P Value |
|---|---|---|---|---|---|---|---|
| SCr, mg/dl | |||||||
| Low (T1) | 0.8–1.4 | 70 | 14.3 | 1 (referent) | 0.04 | 1 (referent) | 0.21 |
| Medium (T2) | 1.5–2.0 | 72 | 23.6 | 1.9 (0.8 to 4.3) | 2.3 (0.8 to 6.6) | ||
| High (T3) | >2.0 | 71 | 32.4 | 2.9 (1.2 to 6.6) | 2.9 (0.8 to 10.5) | ||
| uAGT, μg/g Cr | |||||||
| Low (T1) | 0.04–27.3 | 71 | 7.0 | 1 (referent) | <0.001 | 1 (referent) | <0.001 |
| Medium (T2) | 27.4–146.4 | 71 | 19.7 | 3.2 (1.1 to 9.5) | 3.7 (1.1 to 12.1) | ||
| High (T3) | >146.4 | 71 | 43.7 | 10.2 (3.7 to 28.4) | 10.8 (3.4 to 34.7) | ||
| uNGAL, μg/g Cr | |||||||
| Low (T1) | 0.2–47.4 | 71 | 9.9 | 1 (referent) | <0.001 | 1 (referent) | 0.01 |
| Medium (T2) | 47.5–185.4 | 71 | 21.1 | 2.4 (0.9 to 6.4) | 2.0 (0.7 to 5.7) | ||
| High (T3) | >185.4 | 71 | 39.4 | 5.9 (2.4 to 14.8) | 4.7 (1.7 to 13.4) | ||
| uIL-18, ng/g Cr | |||||||
| Low (T1) | 1.2–38.5 | 70 | 14.3 | 1 (referent) | <0.001 | 1 (referent) | 0.004 |
| Medium (T2) | 38.6–224.4 | 72 | 11.1 | 0.8 (0.3 to 2.0) | 0.8 (0.3 to 2.3) | ||
| High (T3) | >224.4 | 71 | 45.1 | 4.9 (2.2 to 11.1) | 3.6 (1.4 to 9.5) | ||
| uKIM-1, μg/g Cr | |||||||
| Low (T1) | 0.01–2.2 | 71 | 15.5 | 1 (referent) | 0.002 | 1 (referent) | 0.11 |
| Medium (T2) | 2.3–4.6 | 71 | 16.9 | 1.1 (0.5 to 2.7) | 0.9 (0.3 to 2.5) | ||
| High (T3) | >4.6 | 71 | 38.0 | 3.3 (1.5 to 7.5) | 2.1 (0.8 to 5.3) | ||
| UACR, mg/g Cr | |||||||
| Low (T1) | 1.0–104.7 | 71 | 12.7 | 1 (referent) | 0.02 | 1 (referent) | 0.19 |
| Medium (T2) | 104.8–308.5 | 71 | 23.9 | 2.2 (0.9 to 5.2) | 1.7 (0.6 to 4.4) | ||
| High (T3) | >308.5 | 71 | 33.8 | 3.5 (1.5 to 8.2) | 2.5 (0.9 to 6.9) | ||
| pNGAL, ng/ml | |||||||
| Low (T1) | 8.8–151.3 | 71 | 14.1 | 1 (referent) | 0.04 | 1 (referent) | 0.63 |
| Medium (T2) | 151.4–238.0 | 74 | 24.3 | 2.0 (0.8 to 4.6) | 1.5 (0.6 to 4.0) | ||
| High (T3) | >238.0 | 68 | 32.4 | 2.9 (1.3 to 6.8) | 1.2 (0.4 to 3.2) |
AKI progression is defined as worsening of AKI stage (from stage 1 to either stage 2 or 3 or from stage 2 to 3). Biomarkers are measured at the time of stage 1 or 2 AKI diagnosis. SCr, serum creatinine; T, tertile; uAGT, urinary angiotensinogen; uNGAL, urinary neutrophil gelatinase-associated lipocalin; uIL-18, urinary IL-18; uKIM-1, urinary kidney injury molecule-1; UACR, urinary albumin to creatinine ratio; pNGAL plasma neutrophil gelatinase-associated lipocalin.
Adjusted for age, gender, hypertension, diabetes, preadmission eGFR, NT-proBNP, serum albumin, hemoglobin, diuretic dosage before AKI, use of spironolactone before AKI, use of RAS inhibitors before AKI, and change of serum creatinine from baseline at the time of AKI diagnosis. Site is adjusted as a random effect.