Kidney Res Clin Pract.  2021 Dec;40(4):596-610. 10.23876/j.krcp.20.258.

Hepatocyte growth factor and soluble cMet levels in plasma are prognostic biomarkers of mortality in patients with severe acute kidney injury

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
  • 2Department of Intensive Care Unit, Yanbian University Hospital, Jilin, China
  • 3Department of Internal Medicine, Hallym Sacred Heart Hospital, Anyang, Republic of Korea
  • 4Department of Internal Medicine-Nephrology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
  • 5Preliminary Medicine Courses, Seoul National University College of Medicine, Seoul, Republic of Korea
  • 6Department of Internal Medicine-Nephrology, Seoul National University Hospital, Seoul, Republic of Korea
  • 7Department of Internal Medicine-Nephrology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
  • 8Department of Internal Medicine-Nephrology, Seoul National University Bundang Hospital, Republic of Korea

Abstract

Background
Hepatocyte growth factor (HGF)/cMet pathway is necessary for repair and regeneration following acute kidney injury (AKI). We evaluated the clinical potential of plasma HGF and soluble cMet as prognostic biomarkers for severe AKI requiring continuous renal replacement therapy (CRRT).
Methods
One hundred thirty-six patients with severe AKI who participated in the VENUS (volume management under body composition monitoring in critically ill patients on CRRT) trial between 2017 and 2019 were enrolled in this study. We investigated associations between plasma HGF and cMet concentrations and all-cause mortality.
Results
Plasma HGF and soluble cMet levels were positively correlated. Patients were divided into three groups based on their HGF and soluble cMet concentrations. The day D 0, D2, and D7 highest concentration HGF groups had significantly higher in-hospital mortality after adjusting for sex, body mass index, Acute Physiology and Chronic Health Evaluation II, and age-adjusted Charlson comorbidity index score, especially on D7 (hazard ratio, 4.26; 95% confidence interval, 1.71–10.62; p = 0.002). D7 soluble cMet level was also associated with mortality. Receiver operating characteristic curve analysis indicated that D7 HGF and soluble cMet levels were best at predicting mortality. Addition of plasma HGF and soluble cMet to conventional prognostic indices significantly improved the predictive value for mortality on D7. However, plasma HGF and soluble cMet were not associated with fluid status.
Conclusion
Plasma HGF and soluble cMet levels were significant predictors of the outcomes of severe AKI patients undergoing CRRT. There was no correlation between plasma HGF and soluble cMet levels and fluid balance.

Keyword

Acute kidney injury; Biomarkers; Continuous renal replacement therapy; Hepatocyte growth factor; Soluble c-Met
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