Table 3.

Progression of AKI biomarker quintiles with outcome

Biomarker on AKI Day and CategoryCut PointsNAKI Progression (%)P for TrendUnadjusted OR (95% CI)Unadjusted AUC (SE)Adjusted OR (95% CI)aAdjusted AUC (SE)
Serum creatinine
 low (Q1 and Q2)0.8–1.415170.00071 (referent)0.67 (0.04)1 (referent)0.75 (0.04)
 medium (Q3 and Q4)1.41–1.9153101.49 (0.67, 3.32)1.9 (0.7, 5.18)
 high (Q5)1.91–3.376243.95 (1.76, 8.88)3.55 (0.88, 14.29)
Urine albumin to creatinine ratio
 low (Q1 and Q2)0.00–35.014850.00031 (referent)0.67 (0.04)1 (referent)0.78 (0.04)b
 medium (Q3 and Q4)35.0–132.0148142.73 (1.16, 6.42)2.41 (0.97, 5.94)
 high (Q5)>133.074224.83 (1.96, 11.9)3.41 (1.27, 9.11)
Urine NGAL
 low (Q1 and Q2)0.82–20.7150120.0561 (referent)0.58 (0.06)1 (referent)0.79 (0.04)b
 medium (Q3 and Q4)20.8–13415160.46 (0.2, 1.07)0.37 (0.15, 0.93)
 high (Q5)>14175242.32 (1.12, 4.77)2.02 (0.86, 4.73)
Urine IL-18
 low (Q1 and Q2)0.1–29.615080.0021 (referent)0.63 (0.05)1 (referent)0.77 (0.04)b
 medium (Q3 and Q4)29.8–185151101.27 (0.57, 2.81)1.06 (0.44, 2.55)
 high (Q5)>18575243.63 (1.64, 8.03)3.00 (1.25, 7.25)
Plasma NGAL
 low (Q1 and Q2)60–164.51434<0.00011 (referent)0.74 (0.04)1 (referent)0.80 (0.04)b
 medium (Q3 and Q4)164.6–322.6144102.46 (0.92, 6.59)2.53 (0.89, 7.18)
 high (Q5)>322713411.66 (4.49, 30.27)7.72 (2.65, 22.49)
  • AKI progression is defined as worsening of AKIN stage (stage 1 to either stage 2 or 3 or from stage 2 to 3). Site is adjusted as a random effect. OR, odds ratio; CI, confidence interval; AUC, area under the curve; Q, quintile.

  • a Adjusted for age, sex, white race, CPB time>120 minutes, nonelective surgery, preoperative eGFR (<30, 30–60, and >60), diabetes, hypertension, intraoperative IABP, repeat cardiac surgery during the hospitalization, and percent change in postoperative serum creatinine from baseline at the time of AKI diagnosis.

  • b P<0.05 compared with the clinical model alone (clinical model AUC=0.75).