Evidence map›Paper›PMID 32030221›Full record

ArticleJournal of thoracic disease2019

Serum alpha 1-antitrypsin predicts severe acute kidney injury after cardiac surgery.

Songlin Du, Jianwei Tian, Zhiwen Xiao, Zhiwen Luo, Tong Lin, Shaoyi Zheng, Jun Ai

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Songlin DuDepartment of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Jianwei TianState Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Zhiwen XiaoState Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Zhiwen LuoDepartment of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Tong LinState Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Shaoyi ZhengDepartment of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Jun AiState Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nanfang Hospital · CNSouthern Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHuman alpha 1-antitrypsin (A1AT) is involved in the pathophysiological process underlying ischemic acute kidney injury (AKI). To test the hypothesis that serum A1AT (sA1AT) is a predictor for severe AKI after cardiopulmonary bypass (CPB), we conducted a prospective cohort study in 201 patients undergoing cardiac surgery.

methodsWe collected blood and urine samples, and analyzed the sA1AT and other injury biomarkers during the perioperative period. Severe AKI is defined as Kidney Disease Improving Global Outcomes (KDIGO) stage 2 or 3, and overall AKI is defined as KDIGO stage 1, 2, or 3.

resultsNinety-one (45.3%) patients developed overall AKI, and 22 (10.9%) among them developed severe AKI after operation. sA1AT level spiked 2 hours after surgery in patients who subsequently developed severe AKI, while serum creatinine peaked 12 hours after operation. Higher postoperative sA1AT independently correlated to the development of severe AKI [OR, 1.54 (1.17-2.03); P=0.002]. The highest quartile of postoperative sA1AT level was associated with 6-fold higher hazards of severe AKI compared to the lowest quartile. Higher sA1AT levels were correlated with longer stays in the intensive care unit and the hospital. For predicting severe AKI, the AUC of sA1AT 2 hours after CPB reached 0.814. After combining with urine T cell immunoglobulin mucin-1 and clinical model, the AUC improved to 0.923.

conclusionsIn summary, sA1AT is a valuable predictor of severe AKI development and prolonged ICU and hospital stays in patients after cardiac surgery.

Indexed as

acute kidney injury (AKI)cardiac surgerycardiopulmonary bypass (CPB)predictorSerum alpha 1-antitrypsin (sA1AT)

Identifiers

PMID32030221
PMCPMC6988039
OpenAlexW2996475279

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.