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. 2019 May 18;4(8):1131–1142. doi: 10.1016/j.ekir.2019.05.005

Table 2.

Logistic regression assessment of clinical parameters and peak postoperative biomarker levels (independent variables) with the development of postoperative in-hospital AKI (dependent variable)

Odds ratio (95% CI) P Odds ratio (95% CI) P
Clinical model 1
Preoperative eGFR < 60 ml/min per 1.73 m2 1.27 (0.35–4.58) 0.71
Preoperative LVEF % 0.92 (0.87–0.97) 0.003
BMI > 30 kg/m2 5.72 (1.77–18.52) 0.004
Clinical model 2
Cleveland Clinic score 1.14 (0.91–1.42) 0.27
Biomarkers Postoperative 6 h–POD 1 Postoperative 6 h–POD 4
Serum cystatin C 3.81 (1.53–9.48) 0.004 6.93 (2.59–18.59) <0.001
Urine NGAL/Cr 1.17 (0.97–1.45) 0.10 1.33 (1.05–1.67) 0.016
Urine KIM-1/Cr 1.60 (1.06–2.42) 0.026 2.23 (1.41–3.54) <0.001
Combination 1 Serum cystatin C + urine KIM-1/Cr 6.20 (1.71–22.48) 0.006 7.98 (1.98–25.97) 0.003
Combination 2 Serum cystatin C + urine KIM-1/Cr 4.14 (1.50–11.43) 0.006 7.14 (2.54–20.11) <0.001
Biomarkers adjusted by clinical model 1
Serum cystatin C 4.09 (1.11–15.09) 0.035 8.87 (2.34–33.58) 0.001
Urine NGAL/Cr 1.22 (0.92–1.61) 0.17 1.41 (1.03–1.94) 0.030
Urine KIM-1/Cr 1.43 (0.87–2.36) 0.16 2.07 (1.21–3.57) 0.008
Combination 1 Serum cystatin C + urine KIM-1/Cr 5.32 (1.31–21.67) 0.020 6.16 (1.51–25.05) 0.011
Combination 2 Serum cystatin C + urine KIM-1/Cr 3.64 (1.01–13.15) 0.049 4.97 (1.45–17.05) 0.011
Biomarkers adjusted by clinical model 2
Serum cystatin C 4.78 (1.56–14.61) 0.006 9.99 (3.12–32.06) <0.001
Urine NGAL/Cr 1.16 (0.93–1.45) 0.19 1.32 (1.02–1.69) 0.033
Urine KIM-1/Cr 1.56 (1.02–2.38) 0.041 2.22 (1.38–3.57) 0.001
Combination 1 Serum cystatin C + urine KIM-1/Cr 6.02 (1.61–22.55) 0.008 7.15 (1.89–27.00) 0.004
Combination 2 Serum cystatin C + urine KIM-1/Cr 3.94 (1.35–11.44) 0.012 7.03 (2.39–20.70) <0.001

AKI, acute kidney injury; BMI, body mass index (kg/m2); CI, confidence interval; Cr, creatinine; eGFR, estimated glomerular filtration rate (ml/min per 1.73 m2); KIM-1, kidney injury molecule 1; LVEF, left ventricular ejection fraction (%); NGAL, neutrophil gelatinase-associated lipocalin; POD, postoperative day.

Clinical model 1 consisted of 3 preoperative clinical parameters that either were significantly associated with AKI in univariate analysis (preoperative LVEF% and BMI >30 kg/m2) or were clinically relevant for the model (preoperative eGFR <60 ml/min per 1.73 m2). Clinical model 2 was the Cleveland Clinic score validated for predicting AKI–renal replacement therapy following cardiac surgery.30 Duplets of biomarkers were combined as follows: (i) at least 1 biomarker above the cutoff value (combination 1), or (ii) both biomarkers above the cutoff value (combination 2). Biomarker data were log10 transformed and the odds ratios reported correspond to 2-fold higher levels in patients with versus without postoperative AKI.