Evidence map›Paper›PMID 34059102›Full record

Observational studyCritical care (London, England)2021

External validation of urinary C-C motif chemokine ligand 14 (CCL14) for prediction of persistent acute kidney injury.

Sean M Bagshaw, Ali Al-Khafaji, Antonio Artigas, Danielle Davison, Michael Haase, Matthew Lissauer, Kai Zacharowski, Lakhmir S Chawla, Thomas Kwan, J Patrick Kampf and 2 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 1 pooled it
8.0field-weighted citation impact, top 2% 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

40 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 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

12 authors at 9 institutions in 4 countries.

Sean M BagshawDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124 Clinical Sciences Building, 8440-112 ST NW, Edmonton, AB, T6G 2B7, Canada. bagshaw@ualberta.ca.ORCID 0000-0003-3633-6596
Ali Al-KhafajiDepartment of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, 3550 Terrace St., Scaife Hall, Suite 600, Pittsburgh, PA, 15213, USA.
Antonio ArtigasCritical Care Department, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Parc Tauli 1, 08208, Sabadell, Spain.
Danielle DavisonDepartment of Anesthesiology and Critical Care Medicine, School of Medicine and Health Sciences, George Washington University, 900 23rd St. NW, Washington, DC, 20037, USA.
Michael HaaseDiaverum Renal Care Center, 14469 Potsdam, Germany and Medical Faculty, Otto Von-Guericke-University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
Matthew LissauerDivision of Acute Care Surgery, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, 125 Patterson Street, New Brunswick, NJ, 07746, USA.
Kai ZacharowskiDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Lakhmir S ChawlaVeterans Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA.
Thomas KwanAstute Medical, Inc. (a bioMérieux company), 3550 General Atomics Ct, San Diego, CA, 92121, USA.
J Patrick KampfAstute Medical, Inc. (a bioMérieux company), 3550 General Atomics Ct, San Diego, CA, 92121, USA.
Paul McPhersonAstute Medical, Inc. (a bioMérieux company), 3550 General Atomics Ct, San Diego, CA, 92121, USA.
John A KellumDepartment of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, 3550 Terrace St., Scaife Hall, Suite 600, Pittsburgh, PA, 15213, USA.
bioMérieux (United States) · USUniversity of Pittsburgh · USGeorge Washington University · USGoethe University Frankfurt · DEOtto-von-Guericke-Universität Magdeburg · DERutgers, The State University of New Jersey · USUniversitat Autònoma de Barcelona · ESUniversity of Alberta · CAVeterans Health Administration · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPersistent acute kidney injury (AKI) portends worse clinical outcomes and remains a therapeutic challenge for clinicians. A recent study found that urinary C-C motif chemokine ligand 14 (CCL14) can predict the development of persistent AKI. We aimed to externally validate urinary CCL14 for the prediction of persistent AKI in critically ill patients.

methodsThis was a secondary analysis of the prospective multi-center SAPPHIRE study. We evaluated critically ill patients with cardiac and/or respiratory dysfunction who developed Kidney Disease: Improving Global Outcomes (KDIGO) stage 2-3 AKI within one week of enrollment. The main exposure was the urinary concentration of CCL14 measured at the onset of AKI stage 2-3. The primary endpoint was the development of persistent severe AKI, defined as  ≥ 72 h of KDIGO stage 3 AKI or death or renal-replacement therapy (RRT) prior to 72 h. The secondary endpoint was a composite of RRT and/or death by 90 days. We used receiver operating characteristic (ROC) curve analysis to assess discriminative ability of urinary CCL14 for the development of persistent severe AKI and multivariate analysis to compare tertiles of urinary CCL14 and outcomes.

resultsWe included 195 patients who developed KDIGO stage 2-3 AKI. Of these, 28 (14%) developed persistent severe AKI, of whom 15 had AKI  ≥ 72 h, 12 received RRT and 1 died prior to  ≥ 72 h of KDIGO stage 3 AKI. Persistent severe AKI was associated with chronic kidney disease, diabetes mellitus, higher non-renal APACHE III score, greater fluid balance, vasopressor use, and greater change in baseline serum creatinine. The AUC for urinary CCL14 to predict persistent severe AKI was 0.81 (95% CI, 0.72-0.89). The risk of persistent severe AKI increased with higher values of urinary CCL14. RRT and/or death at 90 days increased within tertiles of urinary CCL14 concentration.

conclusionsThis secondary analysis externally validates urinary CCL14 to predict persistent severe AKI in critically ill patients.

Indexed as

Acute Kidney InjuryAgedAPACHEArea Under CurveBiomarkersChemokines, CCFemaleHumansMaleMiddle AgedPredictive Value of TestsProspective StudiesROC CurveBiomarkersCCL14 protein, humanChemokines, CCAcute kidney injuryMortalityPredictionRenal replacement therapyValidation

Identifiers

PMID34059102
PMCPMC8166095
OpenAlexW3165645096

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.