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Annals of Intensive Care

Table 3 Differences in renal outcomes, interventions, and mortality by P-PENK and P-NGAL cut-offs at baseline

From: Predictive value of plasma proenkephalin and neutrophil gelatinase-associated lipocalin in acute kidney injury and mortality in cardiogenic shock

 

All

PENK at 0 h < 84.8 pmol/mL

PENK at 0 h > 84.8 pmol/mL

p value

P-NGAL at 0 h < 104 ng/mL

P-NGAL at 0 h > 104 ng/mL

p value

 

(N = 154)

(N = 61)

(N = 91)

 

(N = 49)

(N = 97)

 

AKI staging at baselinea

       

 Stage 0

21 (14%)

21 (14%)

0 (0%)

< 0.001

17 (12%)

0 (0%)

< 0.001

 Stage 1S

51 (34%)

12 (8%)

38 (26%)

 

13 (9%)

36 (25%)

 

 Stage 1A

16 (11%)

16 (11%)

0 (0%)

 

15 (10%)

0 (0%)

 

 Stage 1B

63 (42%)

11 (7%)

51 (34%)

 

3 (2%)

60 (42%)

 

Detection of AKI by increase in creatinine after baseline

       

 AKI by 12 h

29 (19%)

5 (8%)

23 (25%)

0.05

5 (10%)

24 (25%)

0.006

 AKI 12–24 h

6 (4%)

2 (3%)

4 (4%)

 

1 (2%)

5 (5%)

 

 AKI 24–36 h

10 (7%)

4 (7%)

6 (7%)

 

0 (0%)

9 (9%)

 

 AKI 36–48 h

2 (1%)

0 (0%)

2 (2%)

 

1 (2%)

1(1%)

 

 AKI 48 h-discharge from ICU (5–10 days)b

6 (4%)

2 (3%)

4 (4%)

0.73

3 (6%)

3 (3%)

0.38

 AKI CysC

49 (33%)

17 (29%)

32 (36%)

0.32

9 (18%)

40 (42%)

0.005

 AKI severity by urine output after baseline

       

 No

75 (50%)

37 (61%)

38 (42%)

0.04

31 (63%)

42 (44%)

0.02

 Stage 1

33 (22%)

13 (21%)

20 (22%)

 

11 (22%)

19 (20%)

 

 Stage 2 or 3

43 (29%)

11 (18%)

32 (36%)

 

7 (14%)

35 (37%)

 

AKI severity within 48 h of baseline by creatinine (RRT excluded from staging)

  

0.008

  

0.005

 No AKI

106 (70%)

50 (82%)

56 (61%)

 

42 (86%)

58 (60%)

 

 Stage 1

27 (18%)

9 (15%)

18 (20%)

 

5 (10%)

22 (23%)

 

 Stage 2 or 3 (RRT excluded)

19 (12%)

2 (3%)

17 (19%)

 

2 (4%)

17 (17%)

 

 History of renal insufficiency

17 (11%)

1 (2%)

16 (18%)

0.003

0 (0%)

17 (18%)

0.002

Interventions

       

 Renal replacement therapy

22 (14%)

7 (12%)

15 (17%)

0.49

3 (6%)

19 (20%)

0.048

 Ultrafiltration

11 (8%)

2(4%)

9 (11%)

0.20

2 (5%)

9 (11%)

0.33

 Hemodialysis

7 (5%)

0 (0%)

7 (9%)

0.04

0 (0%)

7 (8%)

0.10

 Use of vasopressors

126 (83%)

50 (82%)

76 (84%)

0.83

41 (84%)

81 (84%)

0.99

 Use of adrenaline

21 (14%)

7 (12%)

14 (15%)

0.63

2 (4%)

18 (19%)

0.02

 Use of noradrenaline

114 (75%)

44 (72%)

70 (77%)

0.57

39 (80%)

73 (75%)

0.68

 Use of dobutamine

25 (16%)

11 (18%)

14 (15%)

0.82

5 (10%)

18 (19%)

0.23

 History of renal insufficiency

17 (11%)

1 (2%)

16 (18%)

0.003

0 (0%)

17 (18%)

0.002

 Coronary angiography

128 (83%)

55 (90%)

71 (78%)

0.08

45 (92%)

75 (77%)

0.04

 Amount of contrast used; mL (SD)

189 (104)

192 (106)

186 (105)

0.72

183 (113)

197 (102)

0.29

 Amount of contrast used per eGFR; mL/eGFR (SD)

3.4 (2.4)

2.5 (1.6)

4.1 (3.0)

0.005

2.3 (1.8)

4.2 (3.6)

< 0.001

 IABP use

86 (57%)

39 (64%)

47 (52%)

0.18

27 (55%)

56 (58%)

0.86

 Intubated

93 (62%)

36 (60%)

57 (63%)

0.73

28 (57%)

61 (64%)

0.47

 LVAD or ECMO

6 (4%)

2 (3%)

4 (4%)

0.99

1 (2%)

4 (4%)

0.66

90-day mortality

58 (38%)

15 (25%)

42 (47%)

0.006

9 (18%)

49 (52%)

< 0.001

  1. Results shown as n (%) for categorical and mean (SD) or median (IQR) for continuous variables
  2. AKI acute kidney injury, CysC cystatin C, ECMO extracorporeal membrane oxygenation, eGFR estimated glomerular filtration rate, IABP intra-aortic balloon pump, ICU intensive care unit, IQR interquartile range, LVAD left ventricular assist device, NGAL neutrophil gelatinase-associated lipocalin, PENK proenkephalin, RRT renal replacement therapy, SD standard deviation
  3. aAKI staging on admission based on urine output and biomarkers, as data on creatinine prior to baseline were unavailable
  4. bKDIGO definition of increase in serum creatinine to 1.5 times baseline or more
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