Critical Care Research and Practice

Clinical Study

Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest

Table 1

Univariate analyses of risk factors for acute kidney injury in resuscitated, comatose out-of-hospital cardiac arrest patients.


	Without AKI ()	With AKI ()	Risk factor for AKI	Crude OR (95% CI) for AKI	value

Baseline data
Age (years)	60.0 ± 13.7	60.2 ± 13.4	Age ≥ 60 years	0.90 (0.51 to 1.58)	0.710
Weight (kg)^a ()	80.0 (75.0 to 90.0)	85.0 (80.0 to 94.5)	Weight ≥ 85 kg	1.73 (0.93 to 3.20)	0.083
Male (sex)	92 (86.0)	73 (83.0)	Female sex	1.26 (0.58 to 2.75)	0.560
Witnessed CA^a ()	98 (92.5)	71 (80.7)	Unwitnessed CA	2.93 (1.20 to 7.17)	0.015
Bystander CPR	96 (89.7)	75 (85.2)	Not bystander CPR	1.51 (0.64 to 3.57)	0.342
ROSC time (min)^a ()	22.0 (15.0 to 29.0)	30.0 (20.0 to 42.5)	Time to ROSC ≥ 25 min	2.16 (1.13 to 4.11)	0.018
Initial VF/VT^a ()	76 (71.0)	52 (59.1)	Not initial VF/VT	1.71 (0.93 to 3.11)	0.081
SAPS II (score)	68.2 ± 10.1	73.1 ± 10.3	SAPS II score ≥ 69	1.92 (1.08 to 3.42)	0.026

Admission day
Diuresis (L/day)	2.26 (1.82 to 3.28)	1.81 (1.43 to 2.45)	Diuresis < 1.93 L/day	3.69 (2.04 to 6.70)	<0.001
Fluid balance (L/day)	4.01 (2.79 to 5.77)	4.74 (3.50 to 6.30)	Fluid balance ≥ 4.45 L/day	1.49 (0.84 to 2.62)	0.169
S-Creatinine (μ·mol/L)	94.0 (81.3 to 105.0)	107.0 (94.0 to 140.0)	S-Creatinine ≥ 101 μ·mol/L	5.18 (2.80 to 9.59)	<0.001
S-Urea (mmol/L)	6.3 (5.2 to 7.5)	7.3 (5.8 to 9.6)	S-Urea ≥ 6.7 mmol/L	2.74 (1.53 to 4.91)	0.001
B-HCO₃⁻ (mmol/L)	20.7 (18.3 to 22.8)	18.9 (16.4 to 21.2)	B-HCO₃⁻ < 19.0 mmol/L	1.95 (1.08 to 3.52)	0.025
B-BE (mmol/L)	−5.6 (−9.1 to −3.6)	−8.9 (−12.4 to −6.1)	B-BE < −7.0 mmol/L	2.68 (1.50 to 4.80)	0.001
B-Lactate (mmol/L)	3.0 (1.7 to 6.5)	5.2 (2.9 to 9.3)	B-Lactate ≥ 4.1 mmol/L	1.92 (1.08 to 3.39)	0.025
SOFA (score)	10.0 (9.0 to 11.0)	11.0 (10.0 to 12.0)	SOFA score ≥ 10	3.73 (1.84 to 7.55)	<0.001

Urine biomarkers ( at admission and at day three)
Adm. β2M (ng/mL)	1856 (364 to 5356)	4393 (833 to 7986)	Adm. β2M ≥ 2769 ng/mL	2.09 (1.18 to 3.70)	0.012
Day 3 β2M (ng/mL)^a	698 (109 to 3832)	412 (67 to 5428)	Day 3 β2M ≥ 627 ng/mL	0.77 (0.41 to 1.44)	0.408
Adm. osteopontin (ng/mL)	1876 (1382 to 2570)	2310 (1791 to 3104)	Adm. osteopontin ≥2068 ng/mL	2.36 (1.33 to 4.21)	0.003
Day 3 osteopontin (ng/mL)^a	1403 (691 to 2395)	2539 (1254 to 4397)	Day 3 osteopontin ≥1683 ng/mL	2.17 (1.15 to 4.12)	0.017
Adm. TFF3 (ng/mL)	2160 (960 to 4084)	3229 (1653 to 5091)	Adm. TFF3, ng/mL ≥ 2694 ng/mL	1.68 (0.95 to 2.97)	0.073
Day 3 TFF3 (ng/mL)^a	2448 (1130 to 4173)	3695 (2111 to 5853)	Day 3 TFF3, ng/mL ≥ 2910 ng/mL	2.32 (1.22 to 4.41)	0.010

Outcome
Hospital RRT	0 (0.0)	8 (9.1)	Treatment with RRT		n.a.
Dead at 6 months	32 (29.9)	56 (63.6)	Death		n.a.
PNO at 6 months	37 (34.6)	59 (67.0)	Poor neurological outcomes		n.a.

Categorical data are presented as number (percent), continuous data with skewed distribution as median (interquartile range), and continuous data with normal distribution as mean (±standard deviation). Presented values are from univariate Pearson’s chi square analysis. AKI: acute kidney injury; OR: odds ratio; CI: confidence interval; : number; CA: cardiac arrest; CPR: cardiopulmonary resuscitation; ROSC: return of spontaneous circulation; VF/VT: ventricular fibrillation/ventricular tachycardia; SAPS: simplified acute physiology score; S: serum; B: whole blood; HCO₃⁻: bicarbonate; BE: base excess; SOFA: sequential organ failure assessment; Adm.: admission; β2M: β-2-microglobulin; TFF3: trefoil factor 3; RRT: renal replacement therapy; PNO: poor neurological outcome defined as cerebral performance category (CPC) 3–5; n.a.: not applicable. ^aData from some patients are missing.