Citation

Suresh MR, Rizzo JA, Sosnov JA, Stacey WN, Howard JT, Tercero JR, Babcock EH, Stewart IJ. J. Burn Care Res. 2020; ePub(ePub): ePub.

Affiliation

Uniformed Services University of Health Sciences, Bethesda, MD.

Copyright

(Copyright © 2020, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/iraa008

PMID

31960038

Abstract

Acute kidney injury (AKI) is associated with high mortality in burn patients. Urinary biomarkers can aid in the prediction of AKI and its consequences, such as death and the need for renal replacement therapy (RRT). The purpose of this study was to investigate a novel methodology for detecting urinary biomarkers, the NephroCheck® Test System, and assess its ability to predict death or the need for RRT in burn patients. Burn patients admitted to the United States Army Institute of Surgical Research (USAISR) burn intensive care unit were prospectively enrolled between March 2016 and April 2018. A urine sample was obtained from all study participants using the NephroCheck® system. Patient and injury characteristics were gathered, and descriptive statistics were calculated and multivariable logistic regression analyses were performed using this data. Of the 69 patients in this study, 15 patients (21.7%) attained the composite outcome of death or needing RRT within 30 days of urine collection. NephroCheck® scores were higher for patients with the composite outcome, with p=0.06 for centrifuged scores and p=0.04 for non-centrifuged scores. Centrifuged and non-centrifuged scores were in high agreement and correlation (R2=0.97, p<0.0001). Non-centrifuged scores were significant in the unadjusted analysis, but they were not significant in the adjusted analysis. Although these scores had a lower sensitivity and negative predictive value compared to other parameters, they had the second highest specificity and positive predictive value. NephroCheck® scores were higher in burn patients with the composite outcome of death or RRT, and they demonstrated comparable sensitivity and specificity to creatinine and TBSA.

Published by Oxford University Press on behalf of the American Burn Association 2020. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Language: en

Keywords

NephroCheck®; acute kidney injury; burns; renal replacement therapy; urinary biomarkers