Urinary L-type fatty acid-binding protein as a new biomarker of sepsis complicated with acute kidney injury*

• DOI: 10.1097/ccm.0b013e3181eedac0
• Publication Date: 2010-07-23T10:01:26Z
• Authors: Kent Doi; Eisei Noiri; Rui Maeda-Mamiya; Tomoko Ishii; Kousuke Negishi; Yoshifumi Hamasaki; Toshiro Fujita; Naoki Yahagi; Hikaru Koide; Takeshi Sugaya; Tsukasa Nakamura
• Keywords: Male; Mice, Transgenic; Acute Kidney Injury; Middle Aged; Fatty Acid-Binding Proteins; Shock, Septic; 3. Good health; Mice, Inbred C57BL; Mice; 03 medical and health sciences; 0302 clinical medicine; Animals; Humans; Female; Prospective Studies; Biomarkers; Aged

Objective: This study is aimed to examine whether urinary L-type fatty acid-binding protein can detect the severity of sepsis with animal models and septic shock patients complicated established acute kidney injury. Design: Experimental a clinical, prospective observational study. Setting: University laboratory tertiary hospital. Subjects Patients: One hundred fourteen human transgenic mice 145 Interventions: Animals were challenged by abdominal (cecal ligation puncture) pulmonary (intratracheal lipopolysaccharide injection) different severities that confirmed survival analysis (n = 24) bronchoalveolar lavage fluid 38). Measurements Main Results: In experiments, significant increases levels induced (severe cecal puncture 399.0 ± 226.8 μg/g creatinine [n 12], less-severe 89.1 25.3 11], sham 13.4 3.4 10] at 6 hrs, p < .05 vs. sham; 200 μg 190.6 77.4 6], 50 145.4 32.6 8], saline 29.9 14.9 5] saline). Urinary predicted more accurately than blood urea nitrogen, serum creatinine, N-acetyl-d-glucosaminidase levels. clinical evaluation, measured admission was significantly higher in nonsurvivors injury survivors (4366 192 68] 483 71 77], .05). showed value area under receiver operating characteristic curve for mortality compared Acute Physiology Chronic Health Evaluation (APACHE) II Sepsis-related Organ Failure Assessment (SOFA) scores (L-type 0.994 [0.956–0.999], APACHE 0.927 [0.873–0.959], SOFA 0.813 [0.733–0.873], Conclusions: Our results suggest be useful biomarker detecting its severity.