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Abstract: SA-PO114

Collagen Type III Biomarkers Are Prognostic for Adverse Outcomes After AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Sparding, Nadja, Nordic Bioscience, Herlev, Herlev , Denmark
  • Genovese, Federica, Nordic Bioscience, Herlev, Herlev , Denmark
  • Karsdal, Morten Asser, Nordic Bioscience, Herlev, Herlev , Denmark
  • Selby, Nicholas M., Centre for Kidney Research and Innovation University of Nottingham, Nottingham, United Kingdom
Background

Acute kidney injury (AKI) is defined as a fast decrease in kidney function and may be associated with structural damage. Even though early markers predicting AKI are emerging, tools to monitor the long-term health risk of patients after AKI are still needed. The novel biomarkers PRO-C3 and C3M are reflecting collagen type III (COL3) formation and degradation, respectively. In this study, we evaluated the potential of these biomarkers of COL3 as prognostic biomarkers of adverse outcomes in patients after AKI.

Methods

We measured PRO-C3 and C3M in plasma samples collected 1 year after the episode of AKI, using novel ELISAs in 800 patients from the AKI Risk in Derby (ARID) study, who were then followed prospectively until year 3. 392 of the patients had been hospitalized for an episode of AKI, and 408 patients who did not sustain AKI were included as controls (non-AKI). Kidney disease progression (KDP) was defined as ≥25% decline in eGFR and a decline in eGFR stage.

Results

By year 3, a total of 42 (AKI=25/control=17) patients had KDP, 70 (43/27) died, 103 (62/41) had heart failure (HF), 193 (104/89) had cardiovascular events (CVEs), and 531 (267/264) were readmitted. We performed multivariate logistic regression analysis with KDP as outcome and Cox regression analysis with mortality, HF, CVE or readmission as outcome with backwards elimination including age, sex, ACR, baseline CKD and diabetes status, eGFR, PRO-C3 and C3M. For KDP, PRO-C3 was retained in the final model in the AKI (OR=1.02, P<0.05) but not the control group, whereas C3M was not retained in the final model in any of the groups. In the AKI group, PRO-C3 retained in the final models for mortality (HR=1.02, P<0.0001), HF (HR=1.01, P<0.05) and readmission (HR=1.00, P<0.05), whereas C3M was retained in the final model for CVEs (1.06, P<0.01). In the control group, PRO-C3 was only retained in the final model for HF (HR=1.01, P<0.01), and C3M was not retained in any of the models.

Conclusion

In this study we showed that biomarkers of COL3 are prognostic for adverse outcomes in patients after AKI. Our findings may indicate that these biomarkers identify patients with active fibrogenesis after AKI, suggesting that long-term renal injury after AKI is important for patient outcome.