Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery
Objectives Increased polyclonal free light chains (FLCs) are found in inflammatory conditions. Inflammation is recognized in the progression of acute kidney injury (AKI). This study was aimed to determine whether polyclonal combined FLC (cFLC) was associated with prognosis of AKI patients. Methods T...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Renal Failure |
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| Online Access: | http://dx.doi.org/10.1080/0886022X.2021.2013886 |
| _version_ | 1798024871113916416 |
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| author | Wenji Wang Lulu Zhang Tianye Yang Shaojun Ma Qi Zhang Peng Shi Feng Ding |
| author_facet | Wenji Wang Lulu Zhang Tianye Yang Shaojun Ma Qi Zhang Peng Shi Feng Ding |
| author_sort | Wenji Wang |
| collection | DOAJ |
| description | Objectives Increased polyclonal free light chains (FLCs) are found in inflammatory conditions. Inflammation is recognized in the progression of acute kidney injury (AKI). This study was aimed to determine whether polyclonal combined FLC (cFLC) was associated with prognosis of AKI patients. Methods This prospective cohort included 145 adults with hospital-acquired AKI following cardiovascular surgery between 2014 and 2016, according to the KDIGO creatinine criteria. The primary end point of the study was all-cause death during follow-up. Results The median of serum cFLC concentration in the cohort was 42.0 (31.9–60.3 mg/L) and levels of cFLC in patients with AKI stage 3 were higher than those in AKI stage 1 and stage 2. cFLC levels correlated significantly with renal function biomarkers, high sensitivity C-reactive protein (hsCRP), and sequential organ failure assessment (SOFA) score. Patients were organized into the following two groups: the low-cFLC group (cFLC <43.3 mg/L) and the high-cFLC group (cFLC ≥ 43.3 mg/L). A total of 17 (11.0%) patient deaths occurred within 90 d, 13 (18.8%) in the high-cFLC group. Kaplan–Meier analysis revealed that the two groups differed significantly with respect to 90-d survival (log-rank p = .012), and Cox regression analysis showed that an cFLC level ≥43.3 mg/L was significantly associated with a 5.0-fold increased risk of death (adjusted hazard ratio [HR], 5.95; 95% confidence interval [CI], 1.04– 33.91; p = .045) compared with an cFLC level <43.3 mg/L. Conclusions Serum cFLC levels were significantly elevated and might be an independent predictor of mortality in patients with AKI following cardiovascular surgery. |
| first_indexed | 2024-04-11T18:10:47Z |
| format | Article |
| id | doaj.art-5142409674254b9ca5493b02a2ab3238 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-11T18:10:47Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-5142409674254b9ca5493b02a2ab32382022-12-22T04:10:09ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492022-12-0144111010.1080/0886022X.2021.20138862013886Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgeryWenji Wang0Lulu Zhang1Tianye Yang2Shaojun Ma3Qi Zhang4Peng Shi5Feng Ding6School of Medicine, Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong UniversitySchool of Medicine, Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong UniversitySchool of Medicine, Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong UniversitySchool of Medicine, Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong UniversitySchool of Medicine, Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong UniversityDepartment of Medical Statistics, Children’s Hospital; Center for Evidence-based Medicine, Fudan UniversitySchool of Medicine, Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong UniversityObjectives Increased polyclonal free light chains (FLCs) are found in inflammatory conditions. Inflammation is recognized in the progression of acute kidney injury (AKI). This study was aimed to determine whether polyclonal combined FLC (cFLC) was associated with prognosis of AKI patients. Methods This prospective cohort included 145 adults with hospital-acquired AKI following cardiovascular surgery between 2014 and 2016, according to the KDIGO creatinine criteria. The primary end point of the study was all-cause death during follow-up. Results The median of serum cFLC concentration in the cohort was 42.0 (31.9–60.3 mg/L) and levels of cFLC in patients with AKI stage 3 were higher than those in AKI stage 1 and stage 2. cFLC levels correlated significantly with renal function biomarkers, high sensitivity C-reactive protein (hsCRP), and sequential organ failure assessment (SOFA) score. Patients were organized into the following two groups: the low-cFLC group (cFLC <43.3 mg/L) and the high-cFLC group (cFLC ≥ 43.3 mg/L). A total of 17 (11.0%) patient deaths occurred within 90 d, 13 (18.8%) in the high-cFLC group. Kaplan–Meier analysis revealed that the two groups differed significantly with respect to 90-d survival (log-rank p = .012), and Cox regression analysis showed that an cFLC level ≥43.3 mg/L was significantly associated with a 5.0-fold increased risk of death (adjusted hazard ratio [HR], 5.95; 95% confidence interval [CI], 1.04– 33.91; p = .045) compared with an cFLC level <43.3 mg/L. Conclusions Serum cFLC levels were significantly elevated and might be an independent predictor of mortality in patients with AKI following cardiovascular surgery.http://dx.doi.org/10.1080/0886022X.2021.2013886acute kidney injuryfree light chainprognosisall-cause mortality |
| spellingShingle | Wenji Wang Lulu Zhang Tianye Yang Shaojun Ma Qi Zhang Peng Shi Feng Ding Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery Renal Failure acute kidney injury free light chain prognosis all-cause mortality |
| title | Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery |
| title_full | Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery |
| title_fullStr | Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery |
| title_full_unstemmed | Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery |
| title_short | Combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery |
| title_sort | combined serum free light chain predicts prognosis in acute kidney injury following cardiovascular surgery |
| topic | acute kidney injury free light chain prognosis all-cause mortality |
| url | http://dx.doi.org/10.1080/0886022X.2021.2013886 |
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