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Acute kidney injury (AKI) is a common complication in hospitalized patients with cirrhosis. Uromodulin, a protein uniquely produced by the kidney and released both in the urine and circulation, has been shown to regulate AKI and is linked to tubular reserve. Although low levels of urine uromodulin are associated with AKI after cardiac surgery, it is unclear whether circulating uromodulin can stratify the risk of AKI, particularly in a susceptible population such as hospitalized patients with cirrhosis. Thus, we investigated if plasma uromodulin measured at the time of admission, is associated with subsequent hospital acquired AKI (defined by a rise in serum creatinine >0.3mg/dL within 48 hours or -> 1.5 times baseline) in patients with cirrhosis. Ninety eight patients [mean age 54 years, Model for Endstage Liver Disease Sodium score (MELD-Na) 19, and baseline creatinine of 0.95 mg/dl] were included, of which 13% (n=13) developed AKI. Median uromodulin levels were significantly lower in patients who developed AKI compared to patients who did not (9.30 vs. 13.35 ng/mL, p=0.02). After adjusting for age, sex, diabetes, hypertension, albumin, and MELD-Na score as co-variates on multivariable logistic regression, uromodulin was independently associated with AKI [OR of 1.19 (95% CI 1.02, 1.37; p=0.02)]. Lower uromodulin levels on admission are associated with increased odds of subsequent AKI in hospitalized patients with cirrhosis. Further studies are needed to better understand the role of uromodulin in the pathogenesis and as a predictive biomarker of AKI in this population.
This article was published in the following journal.
Name: American journal of physiology. Gastrointestinal and liver physiology
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Abrupt reduction in kidney function defined as an absolute increase in serum CREATININE of more than or equal to 0.3. mg/dl, a percentage increase in serum creatinine of more than or equal to 50%, or a reduction in urine output. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.
Acute kidney failure resulting from destruction of EPITHELIAL CELLS of the KIDNEY TUBULES. It is commonly attributed to exposure to toxic agents or renal ISCHEMIA following severe TRAUMA.
The amount of PLASMA flowing to the parts of the KIDNEY that function in the production of urine. It is the amount of plasma perfusing the KIDNEY TUBULES per unit time, generally measured by P-AMINOHIPPURATE clearance. It should be differentiated from RENAL PLASMA FLOW which is approximately 10% greater than the effective renal plasma flow.
A severe irreversible decline in the ability of kidneys to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal failure, either acute (KIDNEY FAILURE, ACUTE) or chronic (KIDNEY FAILURE, CHRONIC), requires HEMODIALYSIS.
Requirements for the selection of students for admission to academic institutions.
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