Intestinal fatty acid–binding protein levels in patients with chronic renal failure

• Published in: The Journal of surgical research Vol. 230; pp. 94 - 100
• Main Authors: Okada, Kyoko, Sekino, Motohiro, Funaoka, Hiroyuki, Sato, Shuntaro, Ichinomiya, Taiga, Murata, Hiroaki, Maekawa, Takuji, Nishikido, Masaharu, Eishi, Kiyoyuki, Hara, Tetsuya
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2018
• Subjects: Biomarker; Critically ill patients; Enterocyte; Glomerular filtration rate; Intestinal ischemia; Renal insufficiency; Biomarker; Renal insufficiency; Enterocyte; Critically ill patients; Intestinal ischemia; Glomerular filtration rate
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2018.04.057

Intestinal fatty acid–binding protein (I-FABP), a biomarker of enterocyte injury, has been reported to be a diagnostic marker of intestinal ischemia and a prognostic marker in critically ill patients. However, the kinetics of I-FABP in renal failure patients is unknown. We sought to identify I-FABP levels in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) on hemodialysis (HD) and to identify the manner in which the I-FABP levels change. Adult patients who were admitted for elective cardiac surgery with either normal renal function (NRF), CKD, or ESKD on HD were enrolled. Serum I-FABP levels in NRF and CKD patients and in ESKD patients before and after HD were determined. A total of 124 patients were evaluated: 47 NRF, 53 CKD, and 24 ESKD. The I-FABP levels of the CKD patients and pre-HD ESKD patients were significantly higher than those of the NRF patients (P = 0.018 and P <0.001, respectively). I-FABP levels were significantly negatively correlated with the estimated glomerular filtration rate in NRF and CKD patients (Spearman's ρ = −0.313, P = 0.002). In addition, I-FABP levels in ESKD patients were significantly lower after HD than those before HD (P <0.001). I-FABP levels in CKD and pre-HD ESKD patients were significantly higher than those in NRF patients. In addition, I-FABP was significantly eliminated by HD in patients with ESKD. Clinicians and researchers should consider this aspect of I-FABP when using it as a diagnostic and prognostic marker in patients with renal insufficiency.