Protein C May Predict Acute Kidney Injury

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MONTREAL—Protein C levels may help determine which critically ill patients will experience acute kidney injury (AKI), according to a study presented at the Canadian Society of Nephrology's 2010 annual meeting.

Previous studies have shown that protein C plays a role in modulating organ survival via it effect on vascular endothelium and its interface with the immune system. The new study, which examined data from 80 patients admitted to intensive care units (ICUs) at hospitals at the University of California, San Diego, the University of Alabama in Birmingham, and the Université de Montréal, showed that lower protein C levels are associated with an increased likelihood of AKI.

AKI developed in 18 subjects after an average of 1.5 days following ICU admission. The AKI patients were slightly older than those without AKI, with an average age of 63.8 versus 54.9 years. A slight majority of both groups were male. The AKI patients were, as expected, significantly more ill. They had higher APACHE III scores and higher sequential organ failure assessment (SOFA) scores.

Protein C levels were more frequently below normal range in patients with AKI than in patients without AKI (32.9% vs. 19.6%). Furthermore, patients in the AKI group had significantly lower protein C levels over the three days before they developed AKI than did non-AKI patients in their first three days after ICU admission (73.8% vs. 91.3%).This remained true when the patients were divided into those with and without sepsis.

One of the investigators, Josée Bouchard, MD, Assistant Professor of Medicine at the Université de Montréal and Hôpital du Sacré-Coeur de Montréal, said protein C levels, as biomarkers of endothelial dysfunction, could help predict which patients will experience AKI.

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