Evaluation of Proenkephalin A 119–159 for liberation from renal replacement therapy: an external, multicenter pilot study in critically ill patients with acute kidney injury
Primary result · Early and successful liberation from CRRT, penKid at CRRT initiationResult — go to the resultSHR for successful liberation from CRRT 1.01 95% CI 0.73–1.40Authors' conclusion
This study suggests that penKid may be a competent biomarker to monitor the recovery of kidney function during CRRT.
Study context
- Population
- Critically ill patients with AKI on continuous renal replacement therapy (CRRT) (RICH Trial)
- Comparison
- Low vs high penKid
- Primary endpoint
- Successful liberation from CRRT (competing endpoint: unsuccessful liberation = death or new RRT within one week of discontinuation)
Methodological detailsexternal validation, multicentre, pilot, competing-risk time-to-event analysis, landmark analysis
- External validation
- Multicentre
- Pilot
- Competing-risk time-to-event analysis
- Landmark analysis
Primary result
As reported in the abstract
Early and successful liberation from CRRT, penKid at CRRT initiation · CRRT initiation
SHR for successful liberation from CRRT
1.01
95% CI 0.73–1.40
P = 0.945
Low penKid vs High penKid
sHR for successful liberation from CRRT 1.01 (95% CI 0.73–1.40); P = 0.945
Further findings
| Outcome | sHR for successful liberation from CRRT (95% CI) | P value | |
|---|---|---|---|
| Successful liberation from CRRT, penKid at day 3 (landmark analysis)Landmark analysis | 2.35 (1.45–3.81) | P < 0.001 | |
| 0.20.5125SHR for successful liberation from CRRT (log scale) |
Unsuccessful liberation from CRRT (death or new RRT within one week), penKid at day 3 (landmark analysis)
| sHR for unsuccessful liberation from CRRT (95% CI) | P value | ||
|---|---|---|---|
| High penKidLandmark analysis | 0.46 (0.26–0.80) | P = 0.007 | |
| 0.20.5125SHR for unsuccessful liberation from CRRT (log scale) |
Successful liberation from CRRT, high daily urinary output (> 436 ml/d)
| sHR for successful liberation from CRRT (95% CI) | P value | ||
|---|---|---|---|
| High daily urinary output (> 436 ml/d)Stronger association than penKid | 2.91 (1.80–4.73) | P < 0.001 | |
| 0.20.5125SHR for successful liberation from CRRT (log scale) |
- Unsuccessful liberation from CRRT (death or new RRT within one week), penKid at day 3 (landmark analysis): as printed: association between high penKid levels and unsuccessful liberation
Original publication
Evaluation of Proenkephalin A 119–159 for liberation from renal replacement therapy: an external, multicenter pilot study in critically ill patients with acute kidney injury. Crit Care. Published 10 July 2023. doi:10.
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