並列タイトル等入院初日の尿中好中球ゼラチナーゼ結合性リポカリンは急性心不全患者の重要な予後予測因子である
タイトル（掲載誌）Journal of the American Heart Association
一般注記type:Thesis
Background Urinary neutrophil gelatinase‐associated lipocalin (U‐NGAL) is an early predictor of acute kidney injury and adverse events in various diseases; however, in acute decompensated heart failure patients, its significance remains poorly understood. This study aimed to investigate the prognostic value of U‐NGAL on the first day of admission for the occurrence of acute kidney injury and long‐term outcomes in acute decompensated heart failure patients. Methods and Results We studied 260 acute decompensated heart failure patients admitted to our department between 2011 and 2014 by measuring U‐NGAL in 24‐hour urine samples collected on the first day of admission. Primary end points were all‐cause eath, cardiovascular death, and heart failure admission. Patients were divided into 2 groups according to their median U‐NGAL levels (32.5 μg/gCr). The high‐U‐NGAL group had a significantly higher occurrence of acute kidney injury during hospitalization than the low‐U‐NGAL group (P=0.0012). Kaplan‐Meier analysis revealed that the high‐U‐NGAL group exhibited a worse prognosis than the low‐U‐NGAL group in all‐cause death (hazard ratio 2.07; 95%CI 1.38‐3.12, P=0.0004), cardiovascular death (hazard ratio 2.29; 95%CI 1.28‐4.24, P=0.0052), and heart failure admission (hazard ratio 1.77; 95%CI 1.13‐2.77, P=0.0119). The addition of U‐NGAL to the estimated glomerular filtration rate significantly improved the predictive accuracy of all‐cause mortality (P=0.0083). Conclusions In acute decompensated heart failure patients, an elevated U‐NGAL level on the first day of admission was related to the development of clinical acute kidney injury and independently associated with poor prognosis.
博士（医学）・甲第675号・平成29年11月24日
Copyright & Usage: © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License(http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
identifier:Journal of the American Heart Association Vol.6 No.5 Article No.e004582 (2017 May)
identifier:20479980
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3386
identifier:Journal of the American Heart Association, 6(5): e004582
DOIinfo:doi/10.1161/JAHA.116.004582
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