Abstract 14694: Combined Assessment of Urinary Liver-Type Fatty-Acid Binding Protein and Albumin Improves Prediction of Acute Kidney Injury in Patients Hospitalized to Coronary Care Units
Background: Urinary concentration of liver-type fatty-acid binding protein (L-FABP) reflects tubulointerstitial damage, and urinary albumin concentration (UAC) reflects glomerular damage. We prospectively investigated the predictive value of urinary L-FABP, both independently and in combination with UAC for acute kidney injury (AKI) which develops after admission to coronary care units (CCUs).
Methods: We studied 1139 patients (mean age of 69 yrs) who admitted to CCUs. Baseline urinary L-FABP and UAC were measured on admission. Among these patients, heart failure was present in 43%, and acute coronary syndrome in 45%. AKI was diagnosed and classified according to the KDIGO criteria.
Results: Urinary L-FABP levels moderately correlated with UAC (r = 0.42, p < 0.0001). AKI occurred in 223 (19.6%) patients. Comparably, patients with AKI were older (73 vs. 71 yrs, p = 0.01), had a higher prevalence of heart failure (51 vs. 41%, p = 0.007), higher levels of B-type natriuretic peptide (377 vs. 206 pg/ml, p < 0.0001) and high-sensitive C-reactive protein (4.2 vs. 2.4 mg/l, p = 0.0001), had higher urinary levels of L-FABP (22.5 vs. 10.5 μg/gCr, p < 0.0001) and UAC (125 vs. 51 mg/gCr, p < 0.0001), and had lower levels of left ventricular ejection fraction (46 vs. 50%, p = 0.04) and estimated glomerular filtration rate (56 vs. 63 ml/min/1.73m2, p = 0.001) compared with those without AKI. Patients with AKI had a higher 6-month mortality rate compared with those without AKI (18 vs. 8%, p = 0.0008). In a multivariate logistic analysis including clinical, biochemical, and echocardiographic parameters, L-FABP (p = 0.04) and UAC (p = 0.008) were independently associated with the development of AKI. The combination of L-FABP and UAC tertiles were associated with increased AKI rates (Figure).
Conclusions: The combination of L-FABP and UAC, which are individually independently predictive of AKI, could improve predictions of AKI in patients hospitalized to CCUs.
Author Disclosures: S. Matsui: None. J. Ishiii: None. H. Takahashi: None. R. Okuyama: None. H. Kawai: None. T. Muramatsu: None. A. Yamada: None. S. Motoyama: None. H. Naruse: None. M. Hayashi: None. H. Izawa: None. Y. Ozaki: None.
- © 2016 by American Heart Association, Inc.