Prognostic Value of Soluble Urokinase-Type Plasminogen Activator Receptor and High-Sensitivity C-Reactive Protein on Postoperative Mortality in Patients Undergoing Elective On-Pump Cardiac Surgery

2020 ◽  
Author(s):  
Sebastian Roed Rasmussen ◽  
Rikke Vibeke Nielsen ◽  
Frank Eriksson ◽  
Maria Dons ◽  
Anne Grønborg Vedel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Plasminogen Activator ◽  
Prognostic Value ◽  
Postoperative Mortality ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Plasminogen Activator Receptor

scholarly journals Prognostic value of suPAR and hsCRP on acute kidney injury after cardiac surgery

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sebastian Roed Rasmussen ◽  
Rikke Vibeke Nielsen ◽  
Rasmus Møgelvang ◽  
Sisse Rye Ostrowski ◽  
Hanne Berg Ravn
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
High Sensitivity ◽  
Reactive Protein ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Adjusted Logistic Regression ◽  
Postoperative Aki

Abstract Background Acute kidney injury (AKI) represents a serious complication following cardiac surgery. Adverse outcome after cardiac surgery has been observed in the presence of elevated levels of soluble urokinase-type plasminogen activator receptor (suPAR) and high-sensitivity C-Reactive Protein (hsCRP). The aim of study was (i) to investigate the relationship between preoperative elevated levels of suPAR and hsCRP and postoperative AKI in unselected cardiac surgery patients and (ii) to assess whether the concentration of the biomarkers reflected severity of AKI. Methods In a retrospective observational study, biobank blood plasma samples (n = 924) from patients admitted for elective on-pump cardiac surgery were analysed for suPAR and hsCRP levels. The relation between suPAR and hsCRP-values and AKI (any stage), defined by the KDIGO (Kidney Disease: Improving Global Outcomes) criteria, was assessed using adjusted logistic regression. Further, the association between biomarkers and severity (KDIGO 1, KDIGO 2–3 and renal replacement therapy (RRT)) was assessed using adjusted logistic regression. Results Postoperative AKI (any stage) was observed in 327 patients (35.4 %). A doubling of preoperative suPAR corresponded to an adjusted odds ratio (OR) for postoperative AKI (any stage) of 1.62 (95 % CI 1.26–2.09, p < 0.001). Furthermore, a doubling of suPAR had an adjusted OR of 1.50 (95 % CI 1.16–1.93, p = 0.002), 2.44 (95 % CI 1.56–3.82, p < 0.001) and 1.92 (95 % CI 1.15–3.23, p = 0.002), for KDIGO 1, KDIGO 2–3 and need for RRT, respectively. No significant association was found between elevated levels of hsCRP and any degree of AKI. Conclusions Increasing levels of suPAR, but not hsCRP, were associated with development and severity of AKI following on-pump cardiac surgery.

scholarly journals Diagnostic and Prognostic Value of Soluble Urokinase-type Plasminogen Activator Receptor (suPAR) in Focal Segmental Glomerulosclerosis and Impact of Detection Method

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Wolfgang Winnicki ◽  
Gere Sunder-Plassmann ◽  
Gürkan Sengölge ◽  
Ammon Handisurya ◽  
Harald Herkner ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Focal Segmental Glomerulosclerosis ◽  
Sensitivity And Specificity ◽  
High Sensitivity ◽  
Test Methods ◽  
Segmental Glomerulosclerosis ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Plasminogen Activator Receptor ◽  
Stage Renal Disease

Abstract The plasma soluble urokinase-type plasminogen activator receptor (suPAR) is a biomarker for focal segmental glomerulosclerosis (FSGS), but its value is under discussion because of ambiguous results arising from different ELISA methods in previous studies. The aim of this study was to compare diagnostic performance of two leading suPAR ELISA kits and examine four objectives in 146 subjects: (1) plasma suPAR levels according to glomerular disease (primary, secondary and recurrent FSGS after kidney transplantation, other glomerulonephritis) and in healthy controls; (2) suPAR levels based on glomerular filtration rate; (3) sensitivity and specificity of suPAR for FSGS diagnosis and determination of optimal cut-offs; (4) suPAR as prognostic tool. Patients with FSGS showed significant higher suPAR values than patients with other glomerulonephritis and healthy individuals. This applied to subjects with and without chronic kidney disease. Although both suPARnostic™ assay and Quantikine Human uPAR ELISA Kit exerted high sensitivity and specificity for FSGS diagnosis, their cut-off values of 4.644 ng/mL and 2.789 ng/mL were significantly different. Higher suPAR was furthermore predictive for progression to end-stage renal disease. In summary, suPAR values must be interpreted in the context of population and test methods used. Knowing test specific cut-offs makes suPAR a valuable biomarker for FSGS.

scholarly journals Does Soluble Urokinase-Type Plasminogen Activator Receptor Level Predicts the Occurrence of Inflammatory Complications in Maxillofacial Surgery?

2021 ◽  
Vol 11 (5) ◽  
pp. 2192
Author(s):  
Marcin Kozakiewicz ◽  
Rafał Nikodem Wlazeł
Keyword(s):  
Plasminogen Activator ◽  
Maxillofacial Surgery ◽  
Patient Characteristics ◽  
Reactive Protein ◽  
Supar Level ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Increased Risk ◽  
Plasminogen Activator Receptor ◽  
Minor Injuries

Soluble urokinase-type plasminogen activator receptor (suPAR) is a marker of immune activation and reflects a more distinct aspect of inflammation than C-reactive protein (CRP) does. The study concerns a clinically silent state of the immune system expressed by the level of suPAR, which could affect the occurrence of complications (non-life threatening) after scheduled procedures. The purpose was the evaluation of suPAR predictive value in minor maxillofacial surgery complication incidents. Eighty patients were tested for suPAR, CRP and a series of basic laboratory serum tests on 1 day before surgery. Complications of orthognathic and minor injuries treatments were reported. The suPAR level, expressed as a measure independent of the patient’s age (Index of Body Inflammation, IBI), was analyzed. The protein level was also assessed on postoperative day 3. Basic statistical analysis did not reveal any relevant dependence between suPAR (or IBI) and occurrence of minor complications. The application of factor analysis, artificial neural network and inclusion of chlorides, glycaemia, alanine transaminase (ALT), albumin and hemoglobin levels allowed to indicate the suPAR/IBI ranges associated with an increased risk of minor postoperative complications. Concluding, it seems that, in the current state of the knowledge, the monitoring of pre-operational suPAR level solely does not include sufficient predictive information for the occurrence of minor complications after maxillofacial surgery. The suPAR/IBI level should be combined with other patient characteristics to predict healing complications.

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