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- Title
CCL14 Predicts Oliguria and Dialysis Requirement in Patients with Moderate to Severe Acute Kidney Injury.
- Authors
Demirjian, Sevag; Chawla, Lakhmir; Davison, Danielle; Forni, Lui G.; Heung, Michael; Hoste, Eric A.J.; Koyner, Jay; Kampf, J. Patrick; Kwan, Thomas; McPherson, Paul; Kellum, John A.
- Abstract
Introduction: AKI is a frequent complication of critical illness and portends poor outcome. CCL14 is a validated predictor of persistent severe AKI in critically ill patients. We examined the association of CCL14 with urine output within 48 h. Methods: In pooled data from 2 studies of critically ill patients with KDIGO stage 2–3 AKI, CCL14 was measured by NEPHROCLEAR™ CCL14 Test on the Astute 140® Meter (low, intermediate, and high categories [1.3 and 13 ng/mL]). Average hourly urine output over 48 h, stage 3 AKI per urine output criterion on day 2, and composite of dialysis or death within 7 days were examined using multivariable mixed and logistic regression models. Results: Of the 497 subjects with median age of 65 (56–74) years, 49% (242/497) were on diuretics. CCL14 concentration was low in 219 (44%), intermediate in 217 (44%), and high in 61 (12%) patients. In mixed regression analysis, hourly urine output over time was different within each CCL14 risk category based on diuretic use due to significant three-way interaction (p < 0.001). In logistic regression analysis, CCL14 risk category was independently associated with low urine output on day 2 per KDIGO stage 3 (adjusted for diuretic use and baseline clinical variables), and composite of dialysis or death within 7 days (adjusted for urine output within 48 h of CCL14 measurement). Conclusions: CCL14 measured in patients with moderate to severe AKI is associated with urine output trajectory within 48 h, oliguria on day 2, and dialysis within 7 days.
- Subjects
ACUTE kidney failure; HEMODIALYSIS patients; LOGISTIC regression analysis; REGRESSION analysis; CRITICALLY ill
- Publication
Blood Purification, 2024, Vol 53, Issue 7, p548
- ISSN
0253-5068
- Publication type
Article
- DOI
10.1159/000538898