Results from the TRIBE-AKI Study Found Associations Between Post-Operative Blood Biomarkers and Risk of Chronic Kidney Disease After Cardiac Surgery

Details

• Personal Author:
  Coca SG ; Garg AX ; Jia Y ; Koyner JL ; Liu C ; Mansour SG ; McArthur E ; Menez S ; Moledina DG ; Obeid W ; Parikh CR ; Shlipak MG ; Thiessen-Philbrook H ; Wilson FP
• Description:
  Patients undergoing cardiac surgery are placed under intense physiologic stress. Blood and urine biomarkers measured peri-operatively may help identify patients at higher risk for adverse long-term kidney outcomes. We sought to determine independent associations of various biomarkers with development or progression of chronic kidney disease (CKD) following cardiac surgery. In this sub-study of the prospective cohort -TRIBE-AKI Study, we evaluated 613 adult patients undergoing cardiac surgery in Canada in our primary analysis and tested the association of 40 blood and urinary biomarkers with the primary composite outcome of CKD incidence or progression. In those with baseline estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73m2, we defined CKD incidence as a 25% reduction in eGFR and an eGFR under 60. In those with baseline eGFR under 60 mL/min/1.73m2, we defined CKD progression as a 50% reduction in eGFR or eGFR under 15. Results were evaluated in a replication cohort of 310 patients from one study site in the United States. Over a median follow-up of 5.6 years, 172 patients developed the primary outcome. Each log increase in basic fibroblast growth factor (adjusted hazard ratio 1.52 [95% confidence interval 1.19, 1.93]), Kidney Injury Molecule-1 (1.51 [0.98, 2.32]), N-terminal pro-B-type natriuretic peptide (1.19 [1.01, 1.41]), and tumor necrosis factor receptor 1 (1.75 [1.18, 2.59]) were associated with outcome after adjustment for demographic factors, serum creatinine, and albuminuria. Similar results were noted in the replication cohort. Although there was no interaction by acute kidney injury in continuous analysis, mortality was higher in the no acute kidney injury group by biomarker tertile. Thus, elevated post-operative levels of blood biomarkers following cardiac surgery were independently associated with the development of CKD. These biomarkers can provide additional value in evaluating CKD incidence and progression after cardiac surgery. [Description provided by NIOSH]
• Subjects:
  Biomarkers Cardiovascular System Cohort Studies Occupational Health Safety
• Keywords:
  Author Keywords: Biomarkers Cardiac Surgery Cardiology CKD Cohort Studies Kidney Disorders Kidneys Medical Treatment Subclinical AKI Surgery
• ISSN:
  0085-2538
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; Connecticut ; Illinois ; Maryland ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  99
• Issue:
  3
• NIOSHTIC Number:
  nn:20062621
• Citation:
  Kidney Int 2021 Mar; 99(3):716-724
• Contact Point Address:
  Chirag R. Parikh, Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St, Ste 416, Baltimore, Maryland 21287, USA
• Email:
  chirag.parikh@jhmi.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20170701
• Source Full Name:
  Kidney International
• End Date:
  20200630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ce94fa473a8a7f606e78c42491729e11fa3dd57680653e78450fe4ef805cf0473b302252453fb50594a355a4b7587d6bb3fed13653e5199dd813968219d36d38
• Download URL:
  https://stacks.cdc.gov/view/cdc/225827/cdc_225827_DS1.pdf
• File Type:
  [PDF - 641.43 KB ]