The urinary levels of prostanoid metabolites predict acute kidney injury in heterogeneous adult Japanese ICU patients: a prospective observational study

Haruyo Ujike-Omori, Yohei Maeshima, Masaru Kinomura, Katsuyuki Tanabe, Kiyoshi Mori, Hiroyuki Watatani, Norikazu Hinamoto, Hitoshi Sugiyama, Yoshiki Sakai, Hiroshi Morimatsu, Hirofumi Makino

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Acute kidney injury (AKI) is frequently observed in critically ill patients in the intensive care unit (ICU) and is associated with increased mortality. Prostanoids regulate numerous biological functions, including hemodynamics and renal tubular transport. We herein investigated the ability of urinary prostanoid metabolites to predict the onset of AKI in critically ill adult patients. Methods: The current study was conducted as a prospective observational study. Urine of patients admitted to the ICU at Okayama University Hospital was collected and the urinary levels of prostaglandin E2 (PGE2), PGI2 metabolite (2,3-dinor-6-OXO-PGF), thromboxane A2 (TXA2) metabolite (11-dehydro-TXB2) were determined. Results: Of the 93 patients, 24 developed AKI (AKIN criteria). Surgical intervention (93, 75 %) was the leading cause of ICU admission. Overall, the ratio of the level of serum Cr on Day 1 after ICU admission to that observed at baseline positively correlated with the urinary 2,3-dinor-6-OXO-PGF/Cr (r = 0.57, p < 0.0001) and 11-dehydro-TXB2/Cr (r = 0.47, p < 0.0001) ratios. In 16 cases of de novo AKI, the urinary 2,3-dinor-6-OXO-PGF/Cr and 11-dehydro-TXB2/Cr values were significantly elevated compared with that observed in the non-AKI group, whereas the urinary PGE2/Cr values were not. The urinary 2,3-dinor-6-OXO-PGF/Cr ratio exhibited the best diagnostic and predictive performance among the prostanoid metabolites according to the receiver operating characteristic (ROC) analysis [ROC–area under the curve (AUC): 0.75]. Conclusions: Taken together, these results demonstrate that the urinary 2,3-dinor-6-OXO-PGF/Cr and 11-dehydro-TXB2/Cr ratios are associated with the subsequent onset of AKI and poor outcomes in adult heterogeneous ICU patients.

Original languageEnglish
Pages (from-to)1024-1036
Number of pages13
JournalClinical and Experimental Nephrology
Volume19
Issue number6
DOIs
Publication statusPublished - Dec 1 2015

Keywords

  • Acute kidney injury
  • ICU
  • Prostaglandin
  • Thromboxane

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

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