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Background and Aims Biomarkers are currently considered as an additional criterion for the diagnosis of AKI. Early diagnosis of AKI is especially important in acute cardiovascular diseases due to increased risk of severe adverse events associated with development of cardiorenal syndrome. The aim of the study to explore the role of biomarkers in early diagnosis of AKI and their prognostic values in patients with acute cardiac diseases. Method 109 patients (51 with acute decompensated heart failure (ADHF), 58 with non-ST-elevation acute coronary syndrome (NSTE-ACS) were examined. Biomarkers of HF (NT-pro BNP in serum) and kidney damage (cystatin C in serum; neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and interleukine-18 (IL-18) in the urine) were estimated. Mann-Whitney test and multivariate logistic regression analysis were performed, p &amp;lt;0.05 was considered statistically significant. Results Patients with vs without AKI had higher levels of NGAL (344±308.8 vs 37.9±65.1 ng/ml, p &amp;lt;0.001) and KIM-1 (0.774±0.36 vs 0.402±0.59 ng/ml, p &amp;lt;0.01) in all groups. Patients with NSTE-ACS with vs without AKI had higher level of NT-proBNP (12857.1±3108.8 vs 10134±2479, p&amp;lt;0.001), no difference was detected in ADHF group. In course of ROC analyses NGAL and KIM-1 showed the best prognostic values (AUC value 0.948 and 0.760). The сut points for NGAL &amp;gt;60.1 ng/ml (sensitivity 87%, specificity 92%) and KIM-1 &amp;gt; 0.519 ng/ml (sensitivity 87%, specificity 67%) were detected, coefficient of association φ was 0,781 and 0,555 respectively. Simultaneous detection of two markers of structural kidney damage (increase of NGAL and/or KIM-1) in high-risk patients permits to diagnose 95% of AKI cases at admission. Patients with AKI and diagnostically significant levels of biomarkers had higher prevalence of CKD (p&amp;lt;0.01), acute heart failure, ADHF (p&amp;lt;0.05) vs those without increase of biomarkers, in-hospital mortality in this group was 29,8%. Conclusion Positive combined biomarker test is an independent and strong predictor of AKI in patients with acute cardiac diseases, and its implementation in clinical practice improve the early diagnostics of AKI when markers of kidney function are still at normal levels.

MO407POSITIVE COMBINED BIOMARKER TEST IS AN INDEPENDENT PREDICTOR OF ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE CARDIAC DISEASES