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. 2022 Mar 6;10(3):613.
doi: 10.3390/biomedicines10030613.

Predictive Value of Urinary Aquaporin 2 for Acute Kidney Injury in Patients with Acute Decompensated Heart Failure

Ming-Jen Chan  1   2 , Yung-Chang Chen  1 , Pei-Chun Fan  1   2 , Cheng-Chia Lee  1   2 , George Kou  1 , Chih-Hsiang Chang  1   2
Affiliations

Predictive Value of Urinary Aquaporin 2 for Acute Kidney Injury in Patients with Acute Decompensated Heart Failure

Ming-Jen Chan et al. Biomedicines. .

Abstract

Acute kidney injury (AKI) is frequently encountered in people with acute decompensated heart failure (ADHF) and is associated with increased morbidity and mortality. Early detection of a urinary biomarker of kidney injury might allow a prompt diagnosis and improve outcomes. Levels of urinary aquaporin 2 (UAQP2), which is also associated with several renal diseases, are increased with ADHF. We aimed to determine whether UAQP2 predicted AKI in patients with ADHF. We conducted a prospective observation study in the coronary care unit (CCU) in a tertiary care university hospital in Taiwan. Individuals with ADHF admitted to the CCU between November 2009 and November 2014 were enrolled, and serum and urinary samples were collected. AKI was diagnosed in 69 (36.5%) of 189 adult patients (mean age: 68 years). Area under the receiver operating characteristic curve (AUROC) of biomarkers was evaluated to evaluate the diagnostic power for AKI. Both brain natriuretic peptide and UAQP2 demonstrated acceptable AUROCs (0.759 and 0.795, respectively). A combination of the markers had an AUROC of 0.802. UAQP2 is a potential biomarker of AKI in CCU patients with ADHF. Additional research on this novel biomarker is required.

Keywords: acute decompensated heart failure; acute kidney injury; coronary care unit; urinary aquaporin 2.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Levels of serum BNP (a) and urine AQP2 (b) across KDIGO stages. Abbreviations: AQP2, aquaporin 2; BNP, brain natriuretic peptide; KDIGO, Kidney Disease: Improving Global Outcomes. Abbreviations: BNP, brain natriuretic peptide; UAQP2, urinary excretion of aquaporin 2; UCr, urine creatinine.
Figure 2
Figure 2
Receiver operating characteristic curves of BNP, UAQP2, and UAQP2/UCr discriminating (a) AKI and (b) composite of AKI stage 3 and in-hospital mortality. Abbreviations: BNP, brain natriuretic peptide; UAQP2, urinary excretion of aquaporin 2; UCr, urine creatinine.
Figure 3
Figure 3
Cumulative mortality rates during 180-day follow-up of patients, with stratification of the optimal cutoff of UAQP2 (a) and UAQP2/UCr (b). Abbreviations: UAQP2, urinary excretion of aquaporin 2; UCr, urine creatinine.
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