危重病患者的 C 端和完整的 FGF23 及其与急性肾损伤和住院死亡率的关系。
C-terminal and intact FGF23 in critical illness and their associations with acute kidney injury and in-hospital mortality.
机构信息
Department of Anesthesiology and Intensive Care, Medical University of Bialystok, ul. M. Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland.
First Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, ul. Zurawia 14, 15-540 Bialystok, Poland.
出版信息
Cytokine. 2018 Mar;103:15-19. doi: 10.1016/j.cyto.2017.12.024. Epub 2017 Dec 27.
BACKGROUND
FGF23 proved its value in prognostication of cardiovascular events and mortality among renal patients and general population. Limited data exist whether FGF23 may have any use in prediction of negative outcomes among critically ill patients admitted to intensive care unit (ICU).
METHODS
Single center cohort study performed among patients admitted to ICU. The primary exposure was FGF23 plasma concentration measured within 24 h of ICU admission. The primary outcome was incident Acute Kidney Injury (AKI) and in-hospital mortality during the ICU stay.
RESULTS
The study enrolled 79 patients admitted to ICU. C-terminal FGF23 (cFGF23) but not intact FGF23 (iFGF23) concentration was significantly elevated in patients, who acquired AKI and non-survivors (p < .001). ROC analysis of cFGF23 yielded an AUC of 0.81 and 0.85 for prediction of incident AKI and death during ICU stay, respectively. Multivariate analysis showed higher odds for AKI (OR 1.80; 95% CI 1.10-2.96) and in-hospital mortality (OR 2.85; 95% CI 1.60-5.06) for one unit increase of log transformed cFGF23.
CONCLUSIONS
cFGF23 measurement may serve as a novel biomarker for incident AKI and death among critically ill patients.
背景
成纤维细胞生长因子 23（FGF23）已被证明可用于预测肾病患者和普通人群的心血管事件和死亡率。目前关于 FGF23 是否可用于预测重症监护病房（ICU）入住患者的不良结局，仅有有限的数据。
方法
这是一项单中心 ICU 患者队列研究。主要暴露因素为 ICU 入住后 24 小时内测量的 FGF23 血浆浓度。主要结局为 ICU 住院期间新发急性肾损伤（AKI）和院内死亡率。
结果
该研究纳入了 79 名入住 ICU 的患者。发生 AKI 和死亡的患者的 C 端 FGF23（cFGF23）而非完整 FGF23（iFGF23）浓度显著升高（p < 0.001）。cFGF23 的 ROC 分析显示，预测 ICU 期间新发 AKI 和死亡的 AUC 分别为 0.81 和 0.85。多变量分析显示，cFGF23 每增加一个对数转换单位，发生 AKI 的几率（OR 1.80；95% CI 1.10-2.96）和院内死亡率（OR 2.85；95% CI 1.60-5.06）的比值比均升高。
结论
cFGF23 测量值可作为 ICU 入住患者新发 AKI 和死亡的新型生物标志物。
Zotero 插件