SLPI - a Biomarker of Acute Kidney Injury after Open and Endovascular Thoracoabdominal Aortic Aneurysm (TAAA) Repair.
Acute Kidney Injury
/ diagnosis
Aged
Aortic Aneurysm, Abdominal
/ surgery
Aortic Aneurysm, Thoracic
/ complications
Area Under Curve
Biomarkers
/ blood
Cardiovascular Diseases
/ epidemiology
Endovascular Procedures
/ adverse effects
Female
Humans
Incidence
Logistic Models
Male
Middle Aged
Postoperative Complications
Prospective Studies
ROC Curve
Secretory Leukocyte Peptidase Inhibitor
/ blood
Sensitivity and Specificity
Sepsis
/ epidemiology
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
26 02 2020
26 02 2020
Historique:
received:
18
10
2019
accepted:
13
02
2020
entrez:
28
2
2020
pubmed:
28
2
2020
medline:
25
11
2020
Statut:
epublish
Résumé
Acute kidney injury (AKI) is a relevant complication following thoracoabdominal aortic aneurysm repair (TAAA). Biomarkers, such as secretory leucocyte peptidase inhibitor (SLPI), may enable a more accurate diagnosis. In this study, we tested if SLPI measured in serum is an appropriate biomarker of AKI after TAAA repair. In a prospective observational single-center study including 33 patients (51.5% women, mean age 63.0 ± 16.2 years) undergoing open and endovascular aortic aneurysm repair in 2017, SLPI was measured peri-operatively (until 72 h after surgery). After surgery, the postoperative complications AKI, as defined according to the KDIGO diagnostic criteria, sepsis, death, MACE (major cardiovascular events) and, pneumonia were assessed. In a subgroup analysis, patients with preexisting kidney disease were excluded. Of 33 patients, 51.5% (n = 17) of patients developed AKI. Twelve hours after admission to the intensive care unit (ICU), SLPI serum levels were significantly increased in patients who developed AKI. Multivariable logistic regression revealed a significant association between SLPI 12 hours after admission to ICU and AKI (P = 0.0181, OR = 1.055, 95% CI = 1.009-1.103). The sensitivity of SLPI for AKI prediction was 76.47% (95% CI = 50.1-93.2) and the specificity was 87.5% (95% CI = 61.7-98.4) with an AUC = 0.838 (95% CI = 0.7-0.976) for an optimal cut-off 70.03 ng/ml 12 hours after surgery. In patients without pre-existing impaired renal function, an improved diagnostic quality of SLPI for AKI was observed (Sensitivities of 45.45-91.67%, Specificities of 77.7-100%, AUC = 0.716-0.932). There was no association between perioperative SLPI and the incidence of sepsis, death, MACE (major cardiovascular events), pneumonia. This study suggests that SLPI might be a post-operative biomarker of AKI after TAAA repair, with a superior diagnostic accuracy for patients without preexisting impaired renal function.
Identifiants
pubmed: 32103084
doi: 10.1038/s41598-020-60482-9
pii: 10.1038/s41598-020-60482-9
pmc: PMC7044192
doi:
Substances chimiques
Biomarkers
0
Secretory Leukocyte Peptidase Inhibitor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3453Références
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