Abstract | OBJECTIVE: DESIGN: Experimental animal models and a clinical, prospective observational study. SETTING: University laboratory and tertiary hospital. SUBJECTS AND PATIENTS: INTERVENTIONS: Animals were challenged by abdominal (cecal ligation and puncture) and pulmonary (intratracheal lipopolysaccharide injection) sepsis models with different severities that were confirmed by survival analysis (n = 24) and bronchoalveolar lavage fluid analysis (n = 38). MEASUREMENTS AND MAIN RESULTS: In animal experiments, significant increases of urinary L-type fatty acid-binding protein levels were induced by sepsis (severe cecal ligation and puncture 399.0 ± 226.8 μg/g creatinine [n = 12], less-severe cecal ligation and puncture 89.1 ± 25.3 [n = 11], sham 13.4 ± 3.4 [n = 10] at 6 hrs, p < .05 vs. sham; 200 μg of lipopolysaccharide 190.6 ± 77.4 μg/g creatinine [n = 6], 50 μg of lipopolysaccharide 145.4 ± 32.6 [n = 8], and saline 29.9 ± 14.9 [n = 5] at 6 hrs, p < .05 vs. saline). Urinary L-type fatty acid-binding protein predicted severity more accurately than blood urea nitrogen, serum creatinine, and urinary N-acetyl-d- glucosaminidase levels. In clinical evaluation, urinary L-type fatty acid-binding protein measured at admission was significantly higher in the nonsurvivors of septic shock with established acute kidney injury than in the survivors (4366 ± 192 μg/g creatinine [n = 68] vs. 483 ± 71 [n = 77], p < .05). Urinary L-type fatty acid-binding protein showed the higher value of area under the receiver operating characteristic curve for mortality compared with Acute Physiology and Chronic Health Evaluation (APACHE) II and Sepsis-related Organ Failure Assessment (SOFA) scores (L-type fatty acid-binding protein 0.994 [0.956-0.999], APACHE II 0.927 [0.873-0.959], and SOFA 0.813 [0.733-0.873], p < .05). CONCLUSIONS:
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Authors | Kent Doi, Eisei Noiri, Rui Maeda-Mamiya, Tomoko Ishii, Kousuke Negishi, Yoshifumi Hamasaki, Toshiro Fujita, Naoki Yahagi, Hikaru Koide, Takeshi Sugaya, Tsukasa Nakamura |
Journal | Critical care medicine
(Crit Care Med)
Vol. 38
Issue 10
Pg. 2037-42
(Oct 2010)
ISSN: 1530-0293 [Electronic] United States |
PMID | 20657273
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Fatty Acid-Binding Proteins
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Topics |
- Acute Kidney Injury
(complications, diagnosis, urine)
- Aged
- Animals
- Biomarkers
(urine)
- Fatty Acid-Binding Proteins
(urine)
- Female
- Humans
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Middle Aged
- Prospective Studies
- Shock, Septic
(complications, diagnosis, urine)
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