AUTHOR=Liu Xiang-Bin , Pang Ke , Tang Yong-Zhong , Le Yuan 

TITLE=The Predictive Value of Pre-operative N-Terminal Pro-B-Type Natriuretic Peptide in the Risk of Acute Kidney Injury After Non-cardiac Surgery

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.898513

DOI=10.3389/fmed.2022.898513

ISSN=2296-858X

ABSTRACT=Abstract
Objective: To evaluate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and  risk of postoperative acute kidney injury (PO-AKI).

Methods: The electronic medical records and laboratory results were obtained from 3949 adult patients  (≥18years) undergoing non-cardiac surgery performed between 1 October 2012 to 1 October 2019 at the Third Xiangya Hospital, Central South University, China. Collected  data were analyzed retrospectively.

Results: In all, 5.3% (209 of 3949) of patients developed PO-AKI. Preoperative NT-proBNP was an independent predictor of PO-AKI. After adjustment for significant variables, OR for AKI of highest and lowest  NT-proBNP quintiles was 1.96 (95% CI, 1.04 to 3.68, P=0.008) ,OR per 1-unit increment in natural log transformed NT-proBNP was 1.20 (95% CI, 1.09 to 1.32, P<0.001).Compared with clinical variables alone, the addition of NT-proBNP modestly improved the discrimination (change in area under the curve(AUC) from 0.82 to 0.83,ΔAUC=0.01,P=0.024) and the reclassification (continuous net reclassification improvement 0.15, 95% CI, 0.01 to 0.29, P=0.034,improved integrated discrimination 0.01, 95% CI, 0.002 to 0.02,P=0.017) of AKI and non-AKI cases. 
Conclusions: Results from our retrospective cohort study showed that the addition of preoperative NT-proBNP concentrations could better predict postoperative AKI in a cohort of non-cardiac surgery patients and achieve higher net benefit in decision curve analysis.