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Fibroblast growth factor 23, endothelium biomarkers and acute kidney injury in critically-ill patients.
de Oliveira Neves, Fernanda Macedo; Araújo, Camila Barbosa; de Freitas, Daniele Ferreira; Arruda, Bianca Fernandes Távora; de Macêdo Filho, Leonardo José Monteiro; Salles, Vivian Brito; Meneses, Gdayllon Cavalcante; Martins, Alice Maria Costa; Libório, Alexandre Braga.
Afiliação
  • de Oliveira Neves FM; Medical Sciences Postgraduate Program, Department of Clinical Medicine, Universidade Federal do Ceará, Avenida Abolição, 4043 Ap 1203, Fortaleza, Ceará, CEP 60165-082, Brazil.
  • Araújo CB; Medical Sciences Postgraduate Program, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceara, Brazil.
  • de Freitas DF; Medical Course, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • Arruda BFT; Medical Course, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • de Macêdo Filho LJM; Medical Course, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • Salles VB; Medical Course, Universidade de Fortaleza-UNIFOR, Fortaleza, Ceará, Brazil.
  • Meneses GC; Medical Sciences Postgraduate Program, Department of Clinical Medicine, Universidade Federal do Ceará, Avenida Abolição, 4043 Ap 1203, Fortaleza, Ceará, CEP 60165-082, Brazil.
  • Martins AMC; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Ceara, Fortaleza, Ceara, Brazil.
  • Libório AB; Medical Sciences Postgraduate Program, Department of Clinical Medicine, Universidade Federal do Ceará, Avenida Abolição, 4043 Ap 1203, Fortaleza, Ceará, CEP 60165-082, Brazil. alexandreliborio@yahoo.com.br.
J Transl Med ; 17(1): 121, 2019 04 11.
Article em En | MEDLINE | ID: mdl-30971270
BACKGROUND: Fibroblast growth factor 23 (FGF23) and endothelium-related biomarkers have been related to AKI in critically-ill patients. Also, FGF23 is associated with endothelial dysfunction. In this study, we investigated if elevated FGF23 association with severe AKI is mediated by several endothelial/glycocalyx-related biomarkers. METHODS: Prospective cohort study with critically-ill patients. Blood samples were collected within the first 24 h after ICU admission. Severe AKI (defined according to KDIGO stage 2/3) was the analyzed outcome. RESULTS: 265 patients were enrolled and 82 (30.9%) developed severe AKI-defined according to KDIGO stage 2/3. Blood samples to biomarkers measurement were collected within the first 24 h after ICU admission. After adjustment for several variables, FGF23, vascular cell adhesion protein 1 (VCAM-1), angiopoietin 2 (AGPT2), syndecan-1 and intercellular adhesion molecule-1 (ICAM-1) were associated with severe AKI. The individual indirect effects of VCAM-1, AGPT2 and syndecan-1 explained 23%, 31%, and 32% of the total observed effect of FGF23 on severe AKI, respectively. ICAM-1 showed no statistically significant mediation. When all three endothelium-related biomarkers were included in a directed acyclic graph (DAG), the Bayesian network learning suggested the following causal association pathway FGF-23 → syndecan-1 → VCAM-1 → AGPT2 → severe AKI. CONCLUSIONS: The association between FGF23 and AKI are mediated by endothelium-related biomarkers, mainly VCAM-1, AGPT2 and syndecan-1. Moreover, the statistical models show that syndecan-1, a biomarker of endothelial glycocalyx dysfunction, seems to be the initial mediator between FGF23 and severe AKI.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estado Terminal / Endotélio / Injúria Renal Aguda / Fatores de Crescimento de Fibroblastos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: J Transl Med Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estado Terminal / Endotélio / Injúria Renal Aguda / Fatores de Crescimento de Fibroblastos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: J Transl Med Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido