BACKGROUND: Community-acquired pneumonia (CAP) is common and associated with a considerable risk of acute kidney injury (AKI). METHODS: We prospectively enrolled 341 patients presenting to the emergency department with CAP (mean age 72, male 61%). Blinded measurements of three natriuretic peptides (NT-proBNP, MR-proANP and BNP) were performed upon presentation. The primary endpoint was the accuracy of the natriuretic peptides to predict AKI within 48h. RESULTS: AKI occurred in 24 patients (7.6%) within the first 48h. NPs and creatinine were significantly higher in AKI compared with patients without AKI (NT-proBNP 9517 [2042-26,792] vs 1177 [280-4167]pg/ml; MR-proANP 641 [196-1075] vs 182 [99-352]pmol/l; BNP 592 [230-1630] vs 160 [64-463]pg/ml; creatinine 166 [131-289] versus 100 [78-134] mumol/l, P>0.001 for each). Predictive accuracy as quantified by the area under the receiver operating characteristics curve was moderate to high: NT-proBNP 0.79 (95%CI 0.70-0.88), MR-proANP 0.78 (95%CI 0.67-0.88), BNP 0.74 (95%CI 0.63-0.85), creatinine 0.77 (95%CI 0.66-0.88). In multivariate logistic regression analysis, NPs remained the only independent AKI predictors: NT-proBNP (increase of 200 pg/ml) OR=1.01, 95%CI 1.00-1.01, P=0.009; MR-proANP (increase of 100 pg/ml) OR=1.23, 95%CI 1.09-1.39, P=0.001; BNP (increase of 100 pg/ml) OR=1.08, 95%CI 1.03-1.14, P=0.002. CONCLUSIONS: NP levels are significantly elevated in CAP-patients experiencing early AKI. Their potential to predict early AKI is comparable to serum creatinine and might be useful in cases of diagnostic uncertainty.
from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2BB2Gfy
via IFTTT
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Abstract Bromodomain proteins function as epigenetic readers that recognize acetylated histone tails to facilitate the transcription of t...
-
Objectives To optimise medical students’ early clerkship is a complex task since it is conducted in a context primarily organised to take ca...
-
Abstract Purpose Overcoming the flaws of current data management conditions in head and neck oncology could enable integrated informatio...
-
C. Julian Chen'Correspondence information about the author C. Julian ChenEmail the author C. Julian Chen, Donald A. Miller DOI: https://...
-
1 abqls-210rm.html Read the latest Journal of Clinical Neurophysiology - Vol. 37, No. 1, January 2020.eml 2 agx3v-nxz96.html Read the late...
-
Ambergris Caye's best News Source. A weekly tourism and community oriented newspaper providing local news, stories, and reports on what...
-
by Yanwei Li, Haifeng Liu, Wei Zeng, Jing Wei An increase in the osmolarity of tears induced by excessive evaporation of the aqueous tear p...
-
http://ift.tt/2p41efZ
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου