Acute kidney disease (AKD) describes acute or subacute damage and/or loss of kidney function for a duration of between 7 and 90 days after exposure to an acute kidney injury (AKI) initiating event. This study investigated the predictive ability of AKI biomarkers in predicting AKD in coronary care unit (CCU) patients. A total of 269 (mean age: 64 years; 202 (75%) men and 67 (25%) women) patients admitted to the CCU of a tertiary care teaching hospital from November 2009 to September 2014 were enrolled. Information considered necessary to evaluate 31 demographic, clinical and laboratory variables (including AKI biomarkers) was prospectively recorded on the first day of CCU admission for post hoc analysis as predictors of AKD. Blood and urinary samples of the enrolled patients were tested for neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC) and interleukin-18 (IL-18). The overall hospital mortality rate was 4.8%. Of the 269 patients, 128 (47.6%) had AKD. Multivariate logistic regression analysis revealed that age, hemoglobin, ejection fraction and serum IL-18 were independent predictors of AKD. Cumulative survival rates at 5 years of follow-up after hospital discharge differed significantly (p < 0.001) between subgroups of patients diagnosed with AKD (stage 0A, 0C, 1, 2 and 3). The overall 5-year survival rate was 81.8% (220/269). Multivariate Cox proportional hazard analysis revealed that urine NGAL, body weight and hemoglobin level were independent risk factors for 5-year mortality. This investigation confirmed that AKI biomarkers can predict AKD in CCU patients. Age, hemoglobin, ejection fraction and serum IL-18 were independently associated with developing AKD in the CCU patients, and urine NGAL, body weight and hemoglobin level could predict 5-year survival in these patients.

中文翻译：

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冠心病监护病房患者的急性肾病和急性肾损伤生物标志物。

急性肾病 (AKD) 描述了在暴露于急性肾损伤 (AKI) 起始事件后 7 至 90 天内的急性或亚急性损伤和/或肾功能丧失。本研究调查了 AKI 生物标志物在预测冠心病监护病房 (CCU) 患者 AKD 方面的预测能力。共纳入 2009 年 11 月至 2014 年 9 月在三级保健教学医院的 CCU 收治的 269 名患者（平均年龄：64 岁；202 名（75%）男性和 67 名（25%）女性）患者。在 CCU 入院第一天前瞻性地记录评估 31 个人口统计学、临床和实验室变量（包括 AKI 生物标志物）所需的信息，用于事后分析，作为 AKD 的预测因子。对入选患者的血液和尿液样本进行中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 检测，胱抑素 C (CysC) 和白细胞介素-18 (IL-18)。整体住院死亡率为4.8%。在 269 名患者中，128 名 (47.6%) 患有 AKD。多变量逻辑回归分析显示年龄、血红蛋白、射血分数和血清 IL-18 是 AKD 的独立预测因子。出院后 5 年随访的累积生存率在诊断为 AKD 的患者亚组（0A、0C、1、2 和 3 期）之间存在显着差异（p < 0.001）。总体 5 年生存率为 81.8% (220/269)。多变量 Cox 比例风险分析显示，尿 NGAL、体重和血红蛋白水平是 5 年死亡率的独立危险因素。这项调查证实了 AKI 生物标志物可以预测 CCU 患者的 AKD。年龄、血红蛋白、