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- Title
Siglec-7 as a Novel Biomarker to Predict Mortality in Decompensated Cirrhosis and Acute Kidney Injury.
- Authors
Allegretti, Andrew; Ortiz, Guillermo; Kalim, Sahir; Wibecan, Joshua; Zhang, Dongsheng; Shan, Hui; Xu, Dihua; Chung, Raymond; Karumanchi, S.; Thadhani, Ravi; Allegretti, Andrew S; Shan, Hui Yi; Chung, Raymond T; Karumanchi, S Ananth; Thadhani, Ravi I
- Abstract
<bold>Background: </bold>Patients with decompensated cirrhosis have high morbidity and are commonly hospitalized with acute kidney injury.<bold>Aims: </bold>We examined serum levels of Siglec-7, a transmembrane receptor that regulates immune activity, as a biomarker for mortality in patients with cirrhosis and acute kidney injury.<bold>Methods: </bold>Serum Siglec-7 was measured in hospitalized patients with cirrhosis and acute kidney injury, as well as in reference groups with acute liver injury/acute kidney injury, cirrhosis without acute kidney injury, and sepsis without liver disease. Clinical characteristics and subsequent outcomes were examined using univariate and multivariable analyses according to initial Siglec-7 levels. Primary outcome was death by 90 days.<bold>Results: </bold>One hundred twenty-eight subjects were included, 92 of which had cirrhosis and acute kidney injury and were used in the primary analysis. Average Model for End-Stage Liver Disease (MELD) score was 24 [95 % CI 23, 26], and serum creatinine was 2.5 [2.2, 2.8] mg/dL at the time Siglec-7 was measured. After adjusting for age and MELD score, high serum Siglec-7 level predicted mortality with a hazard ratio of 1.96 [1.04, 3.69; p = 0.04]. There was no difference in Siglec-7 levels by etiology of AKI (p = 0.24). Addition of serum Siglec-7 to MELD score improved discrimination for 90-day mortality [category-free net reclassification index = 0.38 (p = 0.04); integrated discrimination increment = 0.043 (p = 0.04)].<bold>Conclusion: </bold>Serum Siglec-7 was associated with increased mortality among hospitalized patients with cirrhosis and acute kidney injury. Addition of Siglec-7 to MELD score may increase discrimination to predict 90-day mortality.
- Subjects
CIRRHOSIS of the liver; KIDNEY injuries; SEPSIS; BIOMARKERS; HOSPITAL mortality; MULTIVARIATE analysis; PATIENTS; ACUTE kidney failure; ANTIGENS; CREATININE; HOSPITAL care; LIVER failure; LONGITUDINAL method; PROGNOSIS; PROTEINS; RESEARCH funding; PROPORTIONAL hazards models; SEVERITY of illness index; CASE-control method; ACUTE diseases; DISEASE complications
- Publication
Digestive Diseases & Sciences, 2016, Vol 61, Issue 12, p3609
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-016-4316-x