Research Article

α-Klotho: An Early Risk-Predictive Biomarker for Acute Kidney Injury in Patients with Acute Myocardial Infarction

Table 1

Baseline characteristics in AMI patients with or without AKI.

VariablesTotal (n = 155)AKI group (n = 27)Non-AKI group (n = 128) value

Demography
Age (years)61 ± 1265 ± 1461 ± 120.457
Female (%)20(12.9)9 (33.3)11 (8.6)0.002
Hypertension (%)83 (53.5)15 (55.6)68 (53.1)0.818
DM (%)84 (29.5)7 (25.9)37 (28.9)0.755
Prior MI (%)22 (14.2)4 (14.8)18 (14.1)0.561
CHF (%)3 (1.9)1 (3.7)2 (1.6)0.439
CKD (%)8 (5.2)7 (25.9)1 (0.8)<0.001
Cerebral infarction (%)22 (14.2)7 (25.9)15 (11.7)0.069
Previous PCI (%)19 (12.3)3 (11.1)16 (12.5)0.570
Previous CABG (%)1 (0.1)0 (0.0)1 (0.8)0.826
Chronic lung disease (%)4 (2.6)2 (7.4)2 (1.6)0.140
Dislipidemia (%)26 (16.8)7 (25.9)19 (14.8)0.166
Smoking history (%)108 (69.7)16 (59.3)92 (71.9)0.195

Clinical presentation
Systolic pressure (mmHg)121 ± 25104 ± 31124 ± 220.014
Diastolic pressure (mmHg)72 ± 1662 ± 1674 ± 150.079
Heart rate (bpm)76 (68, 90)96(83, 120)72(66, 84)<0.001
STEMI (%)100 (64.5)23 (85.2)77 (60.2)0.014
Extensive anterior myocardial infarction (%)29 (18.7)15 (55.6)14 (10.9)<0.001
Killip grade ≥III stage (%)15 (9.7)12 (52.2)3 (3.6)<0.001
Cardiogenic shock (%)10 (6.5)9 (33.3)1 (0.8)<0.001
Ventricular tachycardia or fibrillation (%)9 (5.8)7 (25.9)2 (1.6)<0.001
Atrial fibrillation (%)11 (7.1)7 (25.9)4 (3.2)<0.001
Atrioventricular block (%)1 (0.6)0 (0.0)1 (0.8)0.826
Acute heart failure (%)13 (8.4)11 (40.7)2 (1.6)<0.001

Laboratory tests
Hemoglobin (g/L)137 ± 20126 ± 21137 ± 190.007
WBC (×109/L)8.8 (6.9, 11.3)11.4 (8.8, 15.0)8.6 (6.8, 10.5)0.002
PLT (×109/L)196 ± 66202 ± 77208 ± 630.677
SCr at admission (μmol/L)73.0 ± 15.878.2 ± 20.473.3 ± 14.60.140
SCr Max (μmol/L)79.0 (67.0, 91.0)116.0 (103.0, 155.0)73.5 (64.3, 85.0)<0.001
eGFR at admission (ml/min1.73 m2)92.77 (83.36, 100.46)84.70 (64.20, 95.49)93.99 (85.05, 101.22)0.001
The valley eGFR (ml/min1.73 m2)90.06(72.16, 99.35)48.21 (40.68, 67.38)93.80 (84.93, 101.22)<0.001
BUN (mmol/l)5.55 (4.25, 7.06)7.69 (6.61, 10.20)5.11 (4.11, 6.50)<0.001
TNI Max (ng/ml)10.5 (2.7, 55.0)78.0 (15.2, 81.0)7.8 (1.8, 30.9)<0.001
CK-MB (U/L)39.9 (10.2, 190.0)228.3 (32.7, 300.0)33.9(7.9, 123.0)<0.001
BNP at admission (ng/ml)148.5 (75.4, 288.8)300.0 (132.0, 977.0)124.5 (63.0, 250.5)0.001
BNP Max (ng/ml)167.0(79.7, 466.3)783.8 (300.0, 1599.0)131 (63.0, 270.0)<0.001
FBG (mmol/L)6.35 (5.19, 8.40)7.55 (5.99, 10.68)6.20 (5.09, 8.11)0.010
Albumin (g/L)38.4 ± 3.836.5 ± 4.038.8 ± 3.70.005
CHO (mmol/L)4.37 ± 1.084.44 ± 0.884.36 ± 0.110.713
TG (mmol/L)1.51 (1.06, 2.07)1.27 (0.99, 2.13)1.55 (1.08, 2.07)0.295
LDL (mmol/L)2.74 ± 0.872.63 ± 0.792.76 ± 0.880.507
HDL (mmol/L)0.95 (0.83, 1.09)1.03 (0.86, 1.26)0.94 (0.82, 1.06)0.066
LVEF (%)60 ± 1152 (38, 63)64 (58, 68)<0.001

Therapies
Use of furosemide (mg/d)0 (0, 20)40 (40, 80)0 (0, 10)<0.001
Intravenous isosorbide dinitrate (%)104 (67.1)19 (70.4)85 (66.4)0.823
Nonuse of ACEI/ARB (%)54 (34.8)18 (66.7)36 (28.1)<0.001
Use of β-blockers (%)130 (83.9)22 (82.5)108 (84.4)0.710
Use of statins (%)154 (99.4)26 (96.3)128 (100.0)0.221
Vasoactive medication (%)29 (18.7)17 (63.0)12 (9.4)<0.001
IABP (%)12 (7.7)7 (25.9)5 (3.9)0.037
In-hospital PCI (%)111 (71.6)18 (66.7)93 (72.7)0.530
In-hospital CABG (%)10 (6.5)2 (7.4)8 (6.3)0.686
In-hospital mechanical ventilation (%)10 (6.5)5 (18.5)5 (3.9)0.005
Contrast volume (ml)200 (100, 228)200 (100, 300)200 (100, 225)0.480
Thrombolysis therapy (%)4 (2.6)1 (3.7)3 (3.6)0.685

Data expressed as mean ± standard deviation, n (%), or median (interquartile range). DM, diabetes mellitus; MI, myocardial infarction; CHF, congestive heart failure; CKD, chronic kidney disease; PCI, percutaneous coronary intervention. CABG, coronary artery bypass grafting; STEMI, ST-segment elevation myocardial infarction; SCr, serum creatine; eGFR, estimated glomerular filtration rate; FBG, fasting blood glucose; LVEF, left ventricular ejection fraction; Vasoactive medication included dopamine, dobutamine, and norepinephrine. Compared with non-AKI group, was considered significantly.