Bruine, S. de (Suzanne) (2021) NT-proBNP as a prognostic biomarker for acute kidney injury in the intensive care unit. thesis, Medicine.
Full text available on request.Abstract
Introduction Acute kidney injury (AKI) is a commonly encountered clinical problem in the intensive care unit (ICU) which is associated with high morbidity and mortality. Earlier research has identified N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as a possible prognostic biomarker for AKI. The aim of this study was to evaluate whether NT-proBNP measured upon admission to the ICU could be prognostic for the incidence of AKI during the first three days of an ICU stay. Secondary research objectives were to evaluate the prognostic relationship between NT-proBNP and maximum AKI stage and between NT-proBNP and the need for renal replacement therapy (RRT). Methods Using data from the Simple Intensive Care Studies-II cohort (a single-center prospective observational cohort study conducted in the ICU of the University Medical Center Groningen), the association between NT-proBNP and AKI incidence was evaluated using univariate logistic regression. Also, the relationship between NT-proBNP and maximum AKI stage and the need for RRT were evaluated by using univariate logistic regression. The logistic regression analysis for the primary research question was repeated in two sensitivity analyses: 1) excluding patients with myocardial infarct in the six months prior to ICU admission and 2) excluding patients with medication dependent diabetes mellitus. Results Based on a study population of 118 patients, we found no significant association between NT-proBNP and AKI incidence (AUROC 0.60; OR 1.04; 95% CI 0.99-1.10; p=0.13). There were significant associations between NT-proBNP upon admission and maximum AKI stage (OR 1.08; 95% 1.04 – 1.11; p <0.01) and between NT-proBNP upon admission and the need for RRT (AUROC 0.80; OR 1.09; 95% CI 1.04 – 1.15; p <0.01). Conclusion NT-proBNP levels were not prognostic for AKI in this study. However, maximum AKI stage and the need for RRT were significantly associated with NT-proBNP in our research population. Maybe NT-proBNP will prove to be useful within a multifactorial model predicting the progression of AKI in ICUs, but this needs to be further investigated.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Koeze, Dr. J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 10:20 |
| Last Modified: | 07 Jan 2022 10:20 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2995 |
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