4.7 Article

Elevated plasma Galectin-3 is associated with major adverse kidney events and death after ICU admission

Journal

CRITICAL CARE
Volume 26, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s13054-021-03878-x

Keywords

Acute kidney injury; Galectin-3; Major Adverse Kidney Event; Renal biomarker

Funding

  1. Programme Hospitalier de la Recherche Clinique [AON 10-216]
  2. Societe Francaise d'Anesthesie -Reanimation
  3. Sphingotec(R)
  4. Assistance Publique-Hopitaux de Paris [AOR01004]
  5. Societe Francaise d'Anesthesie-Reanimation

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Plasma levels of Gal-3 are strongly associated with renal function, with an increased risk of MAKE and death after ICU admission.
Background: Galectin-3 (Gal-3) is a proinflammatory and profibrotic protein especially overexpressed after Acute Kidney Injury (AKI). The early renal prognostic value of Gal-3 after AKI in critically ill patients remains unexplored. The objective was to evaluate the prognostic value of plasma level of Gal-3 for Major Adverse Kidney Events (MAKE) and mortality 30 days after ICU admission across AKI stages. Methods: This is an ancillary study of a prospective, observational, multicenter cohort (FROG-ICU). AKI was defined using KDIGO definition. Results: Two thousand and seventy-six patients had a Gal-3 plasma level measurement at ICU admission. Seven hundred and twenty-three (34.8%) were females and the median age was 63 [51, 74] years. Eight hundred and seven (38.9%) patients developed MAKE, 774 (37.3%) had AKI and mortality rate at 30 days was 22.4% (N =465). Patients who developed MAKE had higher Gal-3 level at admission compared to patients without (30.2 [20.8, 49.2] ng/ml versus 16.9 [12.7, 24.3] ng/ml, p < 0.001, respectively. The area under the receiver operating characteristic curve of Gal-3 to predict MAKE was 0.76 CI95% [0.74-0.78], p< 0.001. Gal-3 was associated with MAKE (OR 1.80 CI95% [1.68-1.93] p< 0.001, non-adjusted and OR 1.37 CI95% [1.27-1.49], p <0.001, adjusted). The use of Gal-3 improved prediction performance of prediction model including SAPSII, Screat(adm), pNGAL with a NRI of 0.27 CI95% (0.16-0.38), p < 0.001. Median Gal-3 was higher in non-survivors than in survivors at 30 days (29.2 [20.2, 49.2] ng/ml versus 18.8 [13.3, 29.2] ng/ml, p < 0.001, respectively). Conclusion: Plasma levels of Gal-3 were strongly associated with renal function, with an increased risk of MAKE and death after ICU admission.

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