Document Detail

Urinary L-type fatty acid-binding protein as a new biomarker of sepsis complicated with acute kidney injury.
MedLine Citation:
PMID:  20657273     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study is aimed to examine whether urinary L-type fatty acid-binding protein can detect the severity of sepsis with animal sepsis models and septic shock patients complicated with established acute kidney injury.
DESIGN: Experimental animal models and a clinical, prospective observational study.
SETTING: University laboratory and tertiary hospital.
SUBJECTS AND PATIENTS: One hundred fourteen human L-type fatty acid-binding protein transgenic mice and 145 septic shock patients with established acute kidney injury.
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: Our results suggest that urinary L-type fatty acid-binding protein can be a useful biomarker for sepsis complicated with acute kidney injury for detecting its severity.
Kent Doi; Eisei Noiri; Rui Maeda-Mamiya; Tomoko Ishii; Kousuke Negishi; Yoshifumi Hamasaki; Toshiro Fujita; Naoki Yahagi; Hikaru Koide; Takeshi Sugaya; Tsukasa Nakamura
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-21     Completed Date:  2010-10-08     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2037-42     Citation Subset:  AIM; IM    
Department of Nephrology and Endocrinology, Japan Science and Technology Agency/Japan International Cooperation Agency, Science and Technology Research Partnership for Sustainable Development, the University of Tokyo, Tokyo, Japan.
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MeSH Terms
Acute Kidney Injury / complications*,  diagnosis,  urine
Biological Markers / urine*
Fatty Acid-Binding Proteins / urine*
Mice, Inbred C57BL
Mice, Transgenic
Middle Aged
Prospective Studies
Shock, Septic / complications*,  diagnosis,  urine
Reg. No./Substance:
0/Biological Markers; 0/Fatty Acid-Binding Proteins
Comment In:
Crit Care Med. 2010 Oct;38(10):2076-8   [PMID:  20856001 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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