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Kidney Week

Abstract: FR-PO026

Urinary Biomarkers and Renal Recovery at 4 Months After Community Acquired AKI: A Prospective Study in a Tertiary Care Hospital

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Gupta, Krishan Lal L., Postgraduate Institute of Medical Education & Research, Chandigarh, India
  • Nagesh, Vinod, Postgraduate Institute of Medical Education & Research, Chandigarh, India
  • Kumar, Vivek, Postgraduate Institute of Medical Education & Research, Chandigarh, India
  • Mehta, Ravindra L., University of California San Diego Medical Center, La Jolla, California, United States
Background

Acute kidney injury (AKI) in developing countries is most commonly community acquired. Despite advances in the epidemiology of AKI, prognostication remains a significant challenge. We studied the ability of urinary biomarkers to predict renal recovery at four months after community-acquired AKI

Methods

We studied 78 patients with community-acquired AKI (AKIN stage 1 to 3) at the Department of Nephrology, PGIMER, Chandigarh. Serum and urine samples were collected at admission, discharge and, at 1 and four months after discharge. Renal recovery was defined as eGFR (CKD EPI)>60 ml/min/1.73m2 and urine protein to creatinine ratio <500 mg/g at four months after discharge. We investigated whether urinary biomarker (uL-FABP, uNGAL, uKIM-1) at hospital discharge could predict failure to recover renal function at four months after discharge

Results

75(96%) patients had AKIN stage 3 AKI and other 3 patients had AKIN stage 2 AKI. 21(27%) patients had failed to recover renal function at four months of discharge. Median urinary NGAL and urinary KIM-1 were significantly lower in patients with renal recovery (n=57) compared to those with persistent renal dysfunction (n=21). However, the differences in the median urinary L-FABP was not statistically different between the two groups (p-value = 0.55). Urinary NGAL and uKIM-1, individually predicted failure to recover renal function at four months after community-acquired AKI with AUCs of 0.71 (95% CI, 0.26 to 0.55) and 0.68 (95% CI, 0.52 to 0.84), respectively.

Conclusion

This is the first prospective study to evaluate urinary biomarkers as an outcome-specific biomarker in patients with community-acquired AKI cohort. The results of this study indicate that urine NGAL and uKIM-1 are an independent predictor of failure to recover renal function after community-acquired AKI