PD19-05 ELEVATED PROTHROMBIN FRAGMENT 1+2 IS A RISK FACTOR OF SEVERE ACUTE KIDNEY INJURY IN PATIENTS WITH UROLOGICAL SEPSIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD19-05 ELEVATED PROTHROMBIN FRAGMENT 1+2 IS A RISK FACTOR OF SEVERE ACUTE KIDNEY INJURY IN PATIENTS WITH UROLOGICAL SEPSIS Naoki Fujita, Masaki Momota, Osamu Soma, Daisuke Noro, Jotaro Mikami, Shingo Hatakeyama, Hiroyuki Ito, Takahiro Yoneyama, Yasuhiro Hashimoto, Kazuaki Yoshikawa, and Chikara Ohyama Naoki FujitaNaoki Fujita More articles by this author , Masaki MomotaMasaki Momota More articles by this author , Osamu SomaOsamu Soma More articles by this author , Daisuke NoroDaisuke Noro More articles by this author , Jotaro MikamiJotaro Mikami More articles by this author , Shingo HatakeyamaShingo Hatakeyama More articles by this author , Hiroyuki ItoHiroyuki Ito More articles by this author , Takahiro YoneyamaTakahiro Yoneyama More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto More articles by this author , Kazuaki YoshikawaKazuaki Yoshikawa More articles by this author , and Chikara OhyamaChikara Ohyama More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003285.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Elevated prothrombin fragment 1+2 (F1+2), produced during conversion of prothrombin to thrombin, indicates excess thrombin production and serves as a molecular marker of activated coagulation. The aim of this study was to investigate the impact of elevated F1+2 on the development of severe acute kidney injury (AKI) in patients with urological sepsis. METHODS: We prospectively collected the data from 143 patients with urological sepsis between March 2017 and March 2019. AKI was defined according to the KDIGO criteria. Patients were divided into two groups: lower F1+2 (plasma F1+2 levels <395 pmol/L) and higher F1+2 groups (plasma F1+2 levels ≥395 pmol/L). Multivariable logistic regression analysis was performed to evaluate the impact of elevated F1+2 on the severe AKI development. We evaluated predictive ability of elevated F1+2 for the severe AKI development using the receiver operating characteristic curve and compared using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). RESULTS: Median age was 78 years old in this cohort. Of 143 patients, 61 were classified as a higher F1+2 group and 36 developed to severe AKI (AKI stage 2-3). Rate of severe AKI development in the higher F1+2 group was significantly higher than that of the lower F1+2 group (Figure 1A; p=0.004). Plasma F1+2 levels in patients with severe AKI was significantly higher than that in patients with stage 0-1 AKI (Figure 1B; p=0.007). In multivariable analysis, plasma F1+2 level ≥395 pmol/L was selected as a significant independent risk factor for severe AKI development (Figure 1C; hazard ratio 3.067, p=0.006). The predictive ability of hydronephrosis plus elevated F1+2 levels for severe AKI development was significantly improved compared with hydronephrosis alone (Figure 1D). CONCLUSIONS: Elevated prothrombin F1+2 is a risk factor of severe AKI in patients with urological sepsis. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e578 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naoki Fujita More articles by this author Masaki Momota More articles by this author Osamu Soma More articles by this author Daisuke Noro More articles by this author Jotaro Mikami More articles by this author Shingo Hatakeyama More articles by this author Hiroyuki Ito More articles by this author Takahiro Yoneyama More articles by this author Yasuhiro Hashimoto More articles by this author Kazuaki Yoshikawa More articles by this author Chikara Ohyama More articles by this author Expand All Advertisement PDF downloadLoading ...