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Growth differentiation factor 15 as a predictor of acute kidney injury formation

Session Poster session 3

Speaker Associate Professor Irina Vishnevskaya

Event : Heart Failure 2017

  • Topic : cardiovascular disease in special populations
  • Sub-topic : Renal Failure and Cardiovascular Disease
  • Session type : Poster Session

Authors : IR Vishnevskaya (Kharkiv,UA), HF Barahmeh (Kharkiv,UA)

IR Vishnevskaya1 , HF Barahmeh2 , 1Government institution“L.T. Malaya Therapy National institute of the National academy of medical sci - Kharkiv - Ukraine , 2V.N. Karazin Kharkiv National University - Kharkiv - Ukraine ,

European Journal of Heart Failure ( 2017 ) 19 ( Suppl. S1 ), 511

The development of acute kidney injury (AKI) in patient with acute coronary syndrome (ACS), especially in those who underwent angiography, is an actual problem, because it worsens the prognosis. In order to diagnose this condition in time the search for biomarkers is going. Stress-induced marker growth differentiation factor 15 (GDF 15), a member of the transforming growth factor-ß cytokine superfamily is being actively studied.

Purpose: to determine the prognostic significance of GDF 15 and other markers in development of AKI in patients with ACS.

Methods: 73 patients were enrolled with different forms of ACS (55 male and 18 female), mean age was 61, 8 ± 1, 3 years. All patients underwent a baseline investigation which includes: standard electrocardiography, echocardiography, angiography and determination of marker of myocardial necrosis – cardiac troponin T. Based on the results of the examination glomerular filtration rate (GFR) was calculated by Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI). A group of patients has been selected (n= 54), their creatinine level was determined during the first 24 hours and after 48 hours. All patients were divided into two groups according to acute kidney injury network classification (AKIN): 21 patient in the first group with negative dynamic (1st stage AKIN and higher), 33 patient in the second group without creatinine dynamic. In addition, the level of GDF 15 was determined during the first day of hospitalization (normal range of GDF 15 < 1200 pg / ml).

Results: By comparing selected groups significant difference was found in creatinine level and GFR in both groups (?<0.001; ?<0.01, respectively). The effects of various variables were assessed on formation of AKI in patients with different level of GFR. To identify the main risk factors for AKI, we have used logistic regression (LR): ejection fraction of left ventricle (area under curve (AUC) 0.7; p<0.01; 95% confidence interval (CI): 0.560 – 0,842), GDF 15 (AUC 0.77; p<0.03; 95% CI: 0.53 – 0.92) and age (AUC 0.77; p<0.01) were main risk factors for predicting development of AKI. During the statistical analysis the predictive value for estimated parameters was calculated: GDF 15 > 2200 pg/ml (specificity (Spe) 87%, sensitivity (Se) 65%), ejection fraction of left ventricle >46% (Spe 80 %, Se 71 %), age >55 year (Spe 39 %, Se 96 %) We have developed a prognostic model to predict reduced kidney function formation (AUC 0.8; p <0.001). This model with 96% of Se and 68% of Spe can predict development of AKI in patients with different levels of GFR after ACS.

Conclusion: the prognostic multifactor model can be used in clinical practice to improve risk stratification in patients with ACS to prevent formation of AKI.

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