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Erythropoietin concentration in acute kidney injury is associated with insulin‐like growth factor‐binding protein‐1
Author(s) -
Yamashita Tetsushi,
Noiri Eisei,
Hamasaki Yoshifumi,
Matsubara Takehiro,
Ishii Takeshi,
Yahagi Naoki,
Nangaku Masaomi,
Doi Kent
Publication year - 2016
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12656
Subject(s) - medicine , acute kidney injury , erythropoietin , lipocalin , gastroenterology , endocrinology , urinary system , urology
Aim Erythropoietin (EPO) production is stimulated by hypoxia in the kidney. Ischaemic injury plays a crucial role in the pathogenesis of acute kidney injury (AKI). However, EPO concentrations in critically ill patients complicated with AKI have not been evaluated sufficiently. This study was conducted to clarify the factors associated with plasma EPO concentrations in AKI. Methods This study prospectively enrolled 98 critically ill adult patients treated at the adult mixed ICU. Plasma EPO, insulin‐like growth factor‐binding protein‐1 (IGFBP‐1), neutrophil gelatinase‐associated lipocalin (NGAL), interleukin‐6 (IL‐6) and urinary N‐acetyl‐β‐D‐glucosaminidase (NAG) were measured on ICU admission. Results Acute kidney injury occurred in 42 (42.9%) patients. Significantly higher plasma EPO in the AKI group was detected than in the non‐AKI group (16.13 (9.87–28.47) mIU/mL versus 27.81 (10.16–106.02) mIU/mL, P < 0.05). Plasma IGFBP‐1 in the AKI group was also significantly higher than in the non‐AKI group (19 208 (8820–50 780) pg/mL versus 63 199 (25 289–147 489) pg/mL, P < 0.05). Plasma EPO concentration was negatively correlated with haemoglobin in the non‐AKI group with statistical significance, but not in the AKI group. Multiple logistic regression analysis revealed that plasma EPO in the AKI group was associated significantly with plasma IGFBP‐1 and complication of diabetes mellitus, but not the haemoglobin concentration, partial pressure of arterial oxygen (PaO 2 ), and IL‐6. Conclusions Not low arterial oxygen tension, haemoglobin concentration, and inflammation evaluated by IL‐6 but plasma IGFBP‐1 was significantly associated with plasma EPO concentration in AKI, suggesting an unknown mechanism related to systemic stress conditions for EPO regulation in AKI.