Proenkephalin A 119-159 (Penkid) Is an Early Biomarker of Septic Acute Kidney Injury: The Kidney in Sepsis and Septic Shock (Kid-SSS) Study.

Hollinger, Alexa; Wittebole, Xavier; François, Bruno; Pickkers, Peter; Antonelli, Massimo; Gayat, Etienne; Chousterman, Benjamin Glenn; Lascarrou, Jean-Baptiste; Dugernier, Thierry; Di Somma, Salvatore; Struck, Joachim; Bergmann, Andreas; Beishuizen, Albertus; Constantin, Jean-Michel; Damoisel, Charles; Deye, Nicolas; Gaudry, Stéphane; Huberlant, Vincent; Marx, Gernot; Mercier, Emanuelle; Oueslati, Haikel; Hartmann, Oliver; Sonneville, Romain; Laterre, Pierre-François; Mebazaa, Alexandre; Legrand, Matthieu

Hollinger, Alexa; Wittebole, Xavier; François, Bruno; Pickkers, Peter; Antonelli, Massimo; Gayat, Etienne; Chousterman, Benjamin Glenn; Lascarrou, Jean-Baptiste; Dugernier, Thierry; Di Somma, Salvatore; Struck, Joachim; Bergmann, Andreas; Beishuizen, Albertus; Constantin, Jean-Michel; Damoisel, Charles; Deye, Nicolas; Gaudry, Stéphane; Huberlant, Vincent; Marx, Gernot; Mercier, Emanuelle; Oueslati, Haikel; Hartmann, Oliver; Sonneville, Romain; Laterre, Pierre-François; Mebazaa, Alexandre; Legrand, Matthieu.

Afiliação

Hollinger A; Department of Anaesthesiology, Burn and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France.
Wittebole X; INSERM 942, Paris, France.
François B; Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland.
Pickkers P; Department of Critical Care Medicine, St Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
Antonelli M; Intensive Care Unit Department, CHU Dupuytren, Limoges, France.
Gayat E; INSERM CIC 1435/UMR 1092, Limoges, France.
Chousterman BG; Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
Lascarrou JB; Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
Dugernier T; Department of Anaesthesiology, Burn and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France.
Di Somma S; INSERM 942, Paris, France.
Struck J; University Paris Diderot, Paris, France, and INI-CRCT (F-CRIN) network.
Bergmann A; Department of Anaesthesiology, Burn and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France.
Beishuizen A; Centre Hospitalier Universitaire de Nantes, Nantes, France.
Constantin JM; Clinique St Pierre, Ottignies, Belgium.
Damoisel C; Sant' Andrea Hospital, Rome, Italy.
Deye N; Sphingotec GmbH, Hennigsdorf, Germany.
Gaudry S; Sphingotec GmbH, Hennigsdorf, Germany.
Huberlant V; Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands.
Marx G; Department of Perioperative Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
Mercier E; Department of Anaesthesiology, Burn and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Paris, France.
Oueslati H; INSERM 942, Paris, France.
Hartmann O; Centre Hospitalier Universitair de Tours, Tours, France.
Sonneville R; Hôpital Louis Mourier, Colombes, France.
Laterre PF; Hôpital Jolimont, Haine-St-Paul, Belgium.
Mebazaa A; Klinik für Operative Intensivmedizin und Intermediate Care, Universitätsklinikum der RWTH, Aachen, Germany.
Legrand M; Centre Hospitalier Universitair de Tours, Tours, France.

Kidney Int Rep ; 3(6): 1424-1433, 2018 11.

Article em En | MEDLINE | ID: mdl-30450469

ABSTRACT

ABSTRACT

Introduction:

Sepsis is the leading cause of acute kidney injury (AKI) in critically ill patients. The Kidney in Sepsis and Septic Shock (Kid-SSS) study evaluated the value of proenkephalin A 119-159 (penkid)-a sensitive biomarker of glomerular function, drawn within 24 hours upon intensive care unit (ICU) admission and analyzed using a chemiluminescence immunoassay-for kidney events in sepsis and septic shock.

Methods:

The Kid-SSS study was a substudy of Adrenomedullin and Outcome in Severe Sepsis and Septic Shock (AdrenOSS) (NCT02393781), a prospective, observational, multinational study including 583 patients admitted to the intensive care unit with sepsis or septic shock and a validation cohort of 525 patients from the French and euRopean Outcome reGistry in Intensive Care Units (FROG-ICU) study. The primary endpoint was major adverse kidney events (MAKEs) at day 7, composite of death, renal replacement therapy, and persistent renal dysfunction. The secondary endpoints included AKI, transient AKI, worsening renal function (WRF), and 28-day mortality.

Results:

Median age was 66 years (interquartile range 55-75), and 28-day mortality was 22% (95% confidence interval [CI] 19%-25%). Of the patients, 293 (50.3%) were in shock upon ICU admission. Penkid was significantly elevated in patients with MAKEs, persistent AKI, and WRF (median = 65 [IQR = 45-106] vs. 179 [114-242]; 53 [39-70] vs. 133 [79-196] pmol/l; and 70 [47-121] vs. 174 [93-242] pmol/l, all P < 0.0001), also after adjustment for confounding factors (adjusted odds ratio = 3.3 [95% CI = 1.8-6.0], 3.9 [95% CI = 2.1-7.2], and 3.4 [95% CI = 1.9-6.2], all P < 0.0001). Penkid increase preceded elevation of serum creatinine with WRF and was low in renal recovery.