The following is the summary of “Comparison of C-C motif chemokine ligand 14 with other biomarkers for adverse kidney events after cardiac surgery” published in the January 2023 issue of Thoracic and cardiovascular surgery by Massoth, et al.
Both the degree and duration of the insult have an effect on the outcomes of acute renal damage. There is an increased risk of death within 90 days, the need for dialysis or a kidney transplant, and the development of permanent kidney dysfunction in patients with persistent acute kidney injury. Improving health outcomes for these people requires rapid development of diagnostic tools. This research aimed to determine if biomarkers, such as C-C motif chemokine ligand 14, may be used to foretell the occurrence of long-term acute renal damage and significant adverse kidney outcomes following heart surgery.
Prospective, observational study using a single site. In this study, patients who underwent cardiac surgery and subsequently developed moderate or severe acute kidney injury (Kidney Disease Improving Global Outcomes 2 or 3) were enrolled, with the primary end point being the development of persistent severe acute kidney injury (Kidney Disease Improving Global Outcomes 3) lasting 72 hours or more. The primary analysis included 100 patients, 37 of whom achieved the primary end point. With an area under the curve of 0.930 (95% confidence interval of 0.881-0.979), C-C motif chemokine ligand 14 was the most predictive biomarker for the primary end point. C-C motif chemokine ligand 14 has a much larger area under the curve compared to the other biomarkers studied. At baseline, end point positive patients had a higher concentration of C-C motif chemokine ligand 14 (4.47 ng/mL [2.35-11.5] vs. 0.67 ng/mL [0.38-1.07]; P=.001). At a threshold value of 2.21 ng/mL, the sensitivity and specificity were, respectively, 78% and 95%.
Area under the curve equal to 0.915; (95% CI =0.858-0.972; P<.001) for the prediction of renal replacement therapy within 7 days in patients with C-C motif chemokine ligand 14. Persistent acute renal damage after cardiac surgery is associated with elevated levels of C-C motif chemokine ligand 14. Using this novel biomarker may aid in stratifying individuals who will require renal replacement therapy and identifying patients who may benefit from novel treatment approaches to acute kidney damage.