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Clinical and Experimental Nephrology
Erschienen in: Clinical and Experimental Nephrology 6/2015

01.12.2015 | Original Article

The urinary levels of prostanoid metabolites predict acute kidney injury in heterogeneous adult Japanese ICU patients: a prospective observational study

verfasst von: Haruyo Ujike-Omori, Yohei Maeshima, Masaru Kinomura, Katsuyuki Tanabe, Kiyoshi Mori, Hiroyuki Watatani, Norikazu Hinamoto, Hitoshi Sugiyama, Yoshiki Sakai, Hiroshi Morimatsu, Hirofumi Makino

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 6/2015

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Abstract

Background

Acute kidney injury (AKI) is frequently observed in critically ill patients in the intensive care unit (ICU) and is associated with increased mortality. Prostanoids regulate numerous biological functions, including hemodynamics and renal tubular transport. We herein investigated the ability of urinary prostanoid metabolites to predict the onset of AKI in critically ill adult patients.

Methods

The current study was conducted as a prospective observational study. Urine of patients admitted to the ICU at Okayama University Hospital was collected and the urinary levels of prostaglandin E2 (PGE2), PGI2 metabolite (2,3-dinor-6-OXO-PGF1α), thromboxane A2 (TXA2) metabolite (11-dehydro-TXB2) were determined.

Results

Of the 93 patients, 24 developed AKI (AKIN criteria). Surgical intervention (93, 75 %) was the leading cause of ICU admission. Overall, the ratio of the level of serum Cr on Day 1 after ICU admission to that observed at baseline positively correlated with the urinary 2,3-dinor-6-OXO-PGF1α/Cr (r = 0.57, p < 0.0001) and 11-dehydro-TXB2/Cr (r = 0.47, p < 0.0001) ratios. In 16 cases of de novo AKI, the urinary 2,3-dinor-6-OXO-PGF1α/Cr and 11-dehydro-TXB2/Cr values were significantly elevated compared with that observed in the non-AKI group, whereas the urinary PGE2/Cr values were not. The urinary 2,3-dinor-6-OXO-PGF1α/Cr ratio exhibited the best diagnostic and predictive performance among the prostanoid metabolites according to the receiver operating characteristic (ROC) analysis [ROC–area under the curve (AUC): 0.75].

Conclusions

Taken together, these results demonstrate that the urinary 2,3-dinor-6-OXO-PGF1α/Cr and 11-dehydro-TXB2/Cr ratios are associated with the subsequent onset of AKI and poor outcomes in adult heterogeneous ICU patients.
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Metadaten
Titel
The urinary levels of prostanoid metabolites predict acute kidney injury in heterogeneous adult Japanese ICU patients: a prospective observational study
verfasst von
Haruyo Ujike-Omori
Yohei Maeshima
Masaru Kinomura
Katsuyuki Tanabe
Kiyoshi Mori
Hiroyuki Watatani
Norikazu Hinamoto
Hitoshi Sugiyama
Yoshiki Sakai
Hiroshi Morimatsu
Hirofumi Makino
Publikationsdatum
01.12.2015
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 6/2015
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-015-1092-4

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