Kidney Biomarkers and Major Adverse Kidney Events in Critically Ill Patients

Background: Several biomarkers of acute kidney injury (AKI) have been examined for their ability to predict AKI before serum creatinine. Few studies have focused on using kidney biomarkers to better predict major adverse kidney events (MAKE), an increasingly used composite outcome in critical care nephrology research. Methods: Single-center prospective study collecting blood and urine samples from critically ill patients with AKI Kidney Disease: Improving Global Outcomes stage 2 or above, and matched controls from a single, tertiary care intensive care unit. Samples were collected at 24-48 hours after AKI diagnosis (cases) or ICU admission (controls), 5-7 days later, and 4-6 weeks following discharge for AKI patients. The primary outcome of interest was MAKE at hospital discharge (MAKE-DC), consisting of the composite endpoint of death, renal replacement therapy dependence, or a decrease in estimated glomerular filtration to