In:
European Journal of Heart Failure, Wiley, Vol. 18, No. 6 ( 2016-06), p. 641-649
Abstract:
Urinary kidney injury molecule‐1 ( KIM ‐1) is a marker of tubular damage and associated with worse outcome in heart failure ( HF ). Plasma KIM ‐1 has not been described in HF . Methods and results In a renal mechanistic cohort of 120 chronic HF patients, we established the association between plasma KIM ‐1, renal invasive haemodynamic parameters {renal blood flow ([ 131 I ]hippuran clearance) and measured glomerular filtration rate ( GFR ; [ 125 I ]iothalamate)} and urinary tubular damage markers. The association between plasma KIM ‐1, plasma creatinine, and clinical outcome was further explored in a cohort of 2033 acute HF patients. Median plasma KIM ‐1 was 171.5 pg/ mL (122.8–325.7) in chronic ( n = 99) and 295.1 pg/ mL (182.2–484.2) in acute HF ( n = 1588). In chronic HF , plasma KIM ‐1 was associated with GFR ( P 〈 0.001), creatinine, and cystatin C. Plasma KIM ‐1 was associated with urinary N ‐acetyl‐β‐ d ‐glucosaminidase ( NAG ), but not with other urinary tubular damage markers. Log plasma KIM ‐1 predicted adverse clinical outcome after adjustment for age, gender, and GFR [hazard ratio ( HR ) 1.94, 95% confidence interval ( CI ) 1.07–3.53, P = 0.030]. Statistical significance was lost after correction for NT‐proBNP ( HR 1.61, 95% CI 0.81–3.20, P = 0.175). In acute HF , higher plasma KIM ‐1 levels were associated with higher creatinine, lower albumin, and presence of diabetes. Log plasma KIM ‐1 predicted 60‐day HF rehospitalization ( HR 1.27, 95% CI 1.03–1.55, P = 0.024), but not 180‐day mortality or 60‐day death or renal or cardiovascular rehospitalization. Conclusions Plasma KIM ‐1 is associated with glomerular filtration and urinary NAG , but not with other urinary tubular damage markers. Plasma KIM ‐1 does not predict outcome in chronic HF after correction for NT‐proBNP . In acute HF , plasma KIM ‐1 predicts HF rehospitalization in multivariable analysis.
Type of Medium:
Online Resource
ISSN:
1388-9842
,
1879-0844
DOI:
10.1002/ejhf.2016.18.issue-6
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
1500332-2
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