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Kidney Week

Abstract: FR-PO014

Performance of Urinary Osteopontin for the Prediction of AKI Prognosis and Clinical Outcomes in Critically Ill Adults

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Redahan, Lynn, UCD School of Medicine and Medical Science, Dublin 7, Ireland
  • Duff, Stephen, UCD School of Medicine and Medical Science, Dublin 7, Ireland
  • Vencken, Sebastian, University College Dublin, Dublin, Ireland
  • Doran, Peter P., University College Dublin, Dublin, Ireland
  • Murray, Patrick T., UCD School of Medicine and Medical Science, Dublin 7, Ireland

Group or Team Name

  • The Dublin Acute bioMArker Group Evaluation (DAMAGE) Study Group
Background

Osteopontin (OPN) is a secreted phosphoprotein whose expression is upregulated in several experimental models of acute kidney injury (AKI). Due to the localisation of its expression, it has been suggested to be a marker of injury to the ascending limb of the loop of Henle. OPN expression is increased in regenerating proximal tubular cells following injury and it may play a role in renal repair and regeneration. The full extent of the role of OPN in human AKI is incompletely understood. We hypothesised that OPN levels may predict adverse outcomes, such as AKI progression and mortality, in critically ill patients.

Methods

The Dublin Acute Biomarker Group Evaluation (DAMAGE) Study is a prospective multicenter observational study investigating the utility of several urinary biomarkers for the diagnostic and prognostic assessment of AKI in critically ill adults. We conducted a subgroup analysis of this cohort to evaluate whether urinary OPN levels could predict which patients would develop progressive AKI and other adverse clinical outcomes.

Results

The final analysis included a total of 33 patients with a mean age of 59.3 years (S.D. 17.5). Urinary OPN levels normalised to urinary creatinine on Day 1 and on the day of AKI diagnosis did not differ significantly between survivors to day 30 and non-survivors. There was no statistically significant difference in urinary OPN levels between those who met the criteria for progression (a composite of progression to a higher KDIGO AKI stage, renal replacement therapy or death) and those who did not. There was a significant difference in the distributions of urinary OPN levels in patients who survived to the time of ICU discharge and those who did not (p=0.043).

Conclusion

In conclusion, although the sample size for this subset analysis is small, the lack of major difference in estimated risks between groups (odds ratios: ~0.99-1.01 per 100 mg/g OPN/creatinine), even when adjusted for study centre, appears to show that OPN levels measured on Day 1 or on the day of AKI diagnosis is unlikely to be a predictor of AKI progression or survival.