スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Urinary biomarker of kidney tubule injury, risk of acute kidney injury, and mortality in patients with acute ischemic stroke treated at a stroke care unit.
掲載誌名	正式名：European journal of neurology
掲載区分	国外
著者・共著者	Takashi Shimoyama,Takahiro Sato,Yuki Sakamoto,Koichiro Nagai,Junya Aoki,Satoshi Suda,Yasuhiro Nishiyama,Kazumi Kimura
発行年月	2020/07/22
概要	BACKGROUND: Urinary liver-type fatty-acid binding protein (L-FABP), which is a biomarker of kidney tubule injury, has been studied extensively and established as a risk marker of acute kidney injury (AKI). However, no evidence has indicated whether kidney tubule injury is associated with the development of AKI and mortality in patients with acute ischemic stroke. METHODS: Acute ischemic stroke patients hospitalized in the stroke care unit (SCU) within 24 hours after symptom onset were prospectively investigated. AKI was defined on the basis of Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Baseline urinary L-FABP was measured upon admission. We evaluated the association among urinary L-FABP, the incidence of AKI, and 90-day mortality adjusted for renal function, albuminuria, and other potentially predictive variables using the multivariable analysis. RESULTS: In total, 527 acute ischemic stroke patients (342 males; median age 74 years) were enrolled to the study. Twenty-seven patients (5.1%) occurred AKI within 7 days after admission. In the univariate analysis, high urinary L-FABP level had positive associations with AKI (53.8 μg/g Cr vs. 3.9 μg/g Cr, P<0.001) and 90-day mortality (15.5 μg/g Cr vs. 4.0 μg/g Cr, P<0.001). In the multivariate analysis, elevated urinary L-FABP level (per 10 μg/g Cr increase) was independently associated with AKI (Odds ratio 1.225; 95% confidence interval (CI), 1.083-1.454, P=0.003) and 90-day mortality (Hazard ratio 1.091; 95% CI, 1.045-1.138, P<0.001). CONCLUSION: Urinary biomarker of kidney tubule injury is independently associated with the development of AKI and 90-day mortality in patients with acute ischemic stroke treated at the SCU.
DOI	10.1111/ene.14448
PMID	32697875