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Montero-Pérez-Barquero, L. Manzano" "autores" => array:2 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Montero-Pérez-Barquero" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Manzano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256519300827" "doi" => "10.1016/j.rce.2019.03.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256519300827?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419300943?idApp=WRCEE" "url" => "/22548874/0000021900000006/v1_201907300655/S2254887419300943/v1_201907300655/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2254887419300712" "issn" => "22548874" "doi" => "10.1016/j.rceng.2018.09.011" "estado" => "S300" "fechaPublicacion" => "2019-08-01" "aid" => "1589" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Clin Esp. 2019;219:310-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief Original</span>" "titulo" => "Pulmonary embolism in very elderly patients. A diagnostic challenge" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "310" "paginaFinal" => "314" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Embolia pulmonar en los pacientes muy ancianos. Un reto diagnóstico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.C. García Gómez, L. Castilla Guerra, M. Gandullo Moro, R. Cano Alba, M. Paniagua García, M.Á. Colmenero Camacho" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L.C." "apellidos" => "García Gómez" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Castilla Guerra" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Gandullo Moro" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Cano Alba" ] 4 => array:2 [ "nombre" => "M." 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"apellidos" => "Colmenero Camacho" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256518302923" "doi" => "10.1016/j.rce.2018.09.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256518302923?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419300712?idApp=WRCEE" "url" => "/22548874/0000021900000006/v1_201907300655/S2254887419300712/v1_201907300655/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief Original</span>" "titulo" => "Galectina-3 as a biomarker of acute kidney injury risk in patients with decompensated heart failure" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "315" "paginaFinal" => "319" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Sanchez-Serna, M. Martinez-Villanueva, Á. Hernández-Vicente, M.C. Asensio-Lopez, J.A. Noguera, D.A. Pascual-Figal" "autores" => array:6 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Sanchez-Serna" "email" => array:1 [ 0 => "juans87@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Martinez-Villanueva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Á." "apellidos" => "Hernández-Vicente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.C." "apellidos" => "Asensio-Lopez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "J.A." "apellidos" => "Noguera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "D.A." "apellidos" => "Pascual-Figal" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Bioquímica, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Medicina, Facultad Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "CIBER cardiovascular, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Galectina-3 como biomarcador de riesgo de daño renal agudo en pacientes con insuficiencia cardiaca descompensada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1068 "Ancho" => 2489 "Tamanyo" => 149398 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Galectin-3 levels according to acute kidney injury stage.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Galectin-3 (Gal-3) is a biomarker involved in inflammation processes and fibrosis, including cardiac fibrosis,<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1,2</span></a> and has a prognostic value in chronic heart failure (HF) and acute decompensations, and complements the use of natriuretic peptides and other clinical variables.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">3–5</span></a> However, Gal-3 levels are affected by renal function and lose predictive capacity after adjusting for measures of renal function.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">6,7</span></a> Gal-3 levels present little analytic variability, with no significant changes in serial measurements in decompensated HF.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Acute kidney injury (AKI) during decompensated HF is a relevant event that occurs in 25–40% of cases and is associated with adverse intrahospital and outpatient events in the medium to long term.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">9–13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">High Gal-3 levels have been associated in the general population with impaired renal function and an increased incidence of chronic renal failure.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> The aim of this study was to assess whether Gal-3 levels could identify patients with a greater risk of AKI during hospitalization for decompensated HF.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a single-center study that included 175 patients hospitalized in the Cardiology or Internal Medicine ward between November 2009 and January 2017 for decompensated HF and who had a sample at admission in our center's biobank. During the hospitalization, we prospectively collected information on the patients’ history, vital signs, previous treatment and treatment at discharge, laboratory parameters at admission and at discharge, electrocardiogram and echocardiographic assessment (iE33, Philips Medical Systems, Andover, MA). We retrospectively collected creatinine (Cr) readings during hospitalization and during the previous year. The inclusion criteria were hospitalization prompted by symptomatic HF, diagnosed according to current clinical practice guidelines,<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">15,16</span></a> including <span class="elsevierStyleItalic">de novo</span> HF and chronic decompensated HF. We excluded patients with a diagnosis of acute coronary syndrome and those who underwent renal replacement therapy.</p><p id="par0025" class="elsevierStylePara elsevierViewall">All patients underwent standard HF management as recommended by clinical practice guidelines.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">15,16</span></a> The study complied with the Declaration of Helsinki and was approved by the local ethics committee. We obtained written informed consent from all patients for participation in the study, as well as for blood sampling and storage.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Gal-3 concentrations were measured simultaneously from samples taken in the emergency department and preserved in the biobank employing an automated test that quantitatively measured Gal-3 in human serum using an enzyme-linked fluorescence assay (ELFA) technique, which was performed with the miniVidas analyzer (Biomerieux; Marcy-l’Étoile, France).</p><p id="par0035" class="elsevierStylePara elsevierViewall">To define AKI, we used the Risk, Injury, Failure, Loss and End-stage kidney disease (RIFLE) analytic criteria proposed by the Acute Dialysis Quality Initiative (ADQI). RIFLE is a standardized classification that, in the context of HF hospitalizations, has shown superiority over the classical definition of an increase in Cr levels ≥0.3<span class="elsevierStyleHsp" style=""></span>mg/dL.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">17,18</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The baseline Cr reading was the last reading obtained in an outpatient setting (in a primary care or specialized office) prior to admission, with the patient in a stable situation that did not require an intravenous diuretic the week before or after. The presence of AKI was classified into the following 3 stages, based on the variation over at least 24<span class="elsevierStyleHsp" style=""></span>h during the hospitalization with respect to the baseline Cr readings or the estimated glomerular filtration rate (eGFR, measured by the Modification of Diet in Renal Disease-4 equation): stage R (risk), ≥1.5-fold increase in Cr or ≥25% reduction in eGFR; stage I (injury), ≥2-fold increase in Cr or ≥50% reduction in eGFR; and stage F (failure), ≥3-fold increase in Cr or ≥75% reduction in eGFR or Cr level ≥4<span class="elsevierStyleHsp" style=""></span>mg/dL with an increase >0.5<span class="elsevierStyleHsp" style=""></span>mg/dL.</p><p id="par0045" class="elsevierStylePara elsevierViewall">We assessed the normal distribution of the continuous variables with the Kolmogorov-Smirnov test. The data with a normal distribution are listed as mean ± standard deviation, and those with a non-normal distribution are listed as median and interquartile range. The discrete variables are expressed as percentages. We grouped patients according to Gal-3 terciles and compared the differences in the baseline characteristics using an analysis of variance or Kruskal–Wallis test for the continuous variables and the chi-squared test or Fisher's exact test for the discrete variables. We analyzed the predictors of stage I and stage F AKI using Student's <span class="elsevierStyleItalic">t</span>-test or the Mann–Whitney <span class="elsevierStyleItalic">U</span> test for the continuous variables and chi-squared or Fisher's exact test for the discrete variables. We subsequently performed a binary logistic regression multivariate analysis that included those variables with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.1 in the univariate analysis and those predictors of AKI known in the literature. Statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05. All analyses were performed using IBM SPSS statistics software version 22 (IBM Corp., Armonk, NY).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">The mean Gal-3 levels at admission were 25.3 (17–36.3) ng/mL. The mean age of the 175 included patients was 72.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.1 years, and 39% were women. Fifty-one percent of the patients presented ischemic heart disease, and the mean left ventricular ejection fraction was 44.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15.5%. Most of the patients were previously in New York Heart Association (NYHA) functional class II-III (78%). The eGFR at admission was 58.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>25.7<span class="elsevierStyleHsp" style=""></span>mL/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>, while the baseline eGFR was 61.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>26.4<span class="elsevierStyleHsp" style=""></span>mL/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> (the time between the baseline measurement and admission was 43 [12–143] days). The patients with higher Gal-3 levels at admission (those of the higher tercile) had a higher percentage of ischemic heart disease, poorer renal function readings (at baseline and admission) and higher amino-terminal fragment of the brain natriuretic peptide (NT-proBNP) readings at admission.</p><p id="par0055" class="elsevierStylePara elsevierViewall">During the hospitalization, 44 (25.1%) patients developed stage R AKI, 9 developed stage I (5.1%), and 5 developed stage F (2.9%), while 117 (66.9%) did not meet the criteria for AKI. Given the few cases observed, stages I and F were grouped for the analysis. Gal-3 levels at admission were highest in those who developed stages I and F AKI (No AKI, 24.2 [16.2–36.4] ng/mL; stage R, 25.0 [18.3–31.2] ng/mL; stages I and F, 39.1 [31.8–61.0] ng/mL; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.003 [<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>]). There were no differences in the time between the baseline measurement and admission according to stage (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.23).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">In addition to high Gal-3 levels, high NT-proBNP levels at admission, lower baseline and admission eGFR and the presence of a reduced left ventricular ejection fraction were shown to be predictors of stage I and stage F AKI. After the multivariate analysis with these variables and with variables of recognized biological importance (age, arterial hypertension and diabetes mellitus), however, only Gal-3 levels at admission remained a predictor of stage I and stage F AKI (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">The availability of renal risk markers beyond the conventional measures represents an area of interest and potential clinical translation. Our results suggest a pathophysiological relationship between Gal-3 and renal function, thereby supporting, for the first time, its usefulness as a risk marker for predicting AKI in acute decompensated HF.</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the context of decompensated HF, AKI can precede the hospitalization and become established by this time in up to 50% of the cases.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">10,19</span></a> We therefore propose that the definition of AKI in HF take into consideration the 7 days prior to admission.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a> There are studies that have shown that using outpatient baseline values improves the diagnostic and prognostic capacity.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Several prior studies have found an inverse relationship between plasma Gal-3 levels and renal function.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> To date, this is the first study to observe a relationship between the presence of high Gal-3 levels and the development of AKI in decompensated HF, a relationship that remained after adjusting for baseline renal function and other predictors of AKI. This relationship could change our understanding of the role of Gal-3 as a biomarker. Within the context of HF, Gal-3 is involved in the processes of inflammation and remodeling of the extracellular matrix and could also be a marker of renal risk or susceptibility for developing acute impairment, in situations of hemodynamic and neurohormonal stress, as is the case in decompensated HF.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The study has certain limitations given that it is a single-center study with a small sample. Given the study's observational nature, the results should be interpreted with caution and should mainly be considered a generator of hypotheses. Although a correlation was observed, causality cannot be attributed to the relationship between Gal-3 and AKI. Regardless, although new studies are needed to confirm the findings, predicting the risk of renal impairment is an area of special clinical importance, and our results, along with previous evidence, warrant new research.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0085" class="elsevierStylePara elsevierViewall">In patients hospitalized for decompensated HF, the presence of high Gal-3 levels was associated with a higher risk of worsening renal function. Future studies should confirm this finding, which could represent an improvement in renal risk stratification over currently available measures.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Authorship</span><p id="par0090" class="elsevierStylePara elsevierViewall">Drafting, review and approval of the submitted manuscript: Juan Sanchez-Serna, Álvaro Hernández-Vicente, Jose A. Noguera, Domingo A. Pascual-Figal.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1225424" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1139224" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1225425" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1139225" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Authorship" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-06-07" "fechaAceptado" => "2018-10-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1139224" "palabras" => array:4 [ 0 => "Biomarkers" 1 => "Heart Failure" 2 => "Acute kidney injury" 3 => "Galectina-3" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1139225" "palabras" => array:4 [ 0 => "Biomarcadores" 1 => "Insuficiencia cardiaca" 2 => "Daño renal agudo" 3 => "Galectina-3" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">In decompensated heart failure (HF), both acute kidney injury (AKI) and high Galectina-3 (Gal-3) levels have been associated with poorer outcomes. Plasma Gal-3 levels are affected by renal function; however, the potential role of Gal-3 as a predictor of AKI has not been established.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We measured Gal-3 concentrations at admission for 175 patients hospitalized for HF and recorded the onset of AKI according to the Risk, Injury, Failure, Loss and End-stage kidney disease (RIFLE) analytical criteria.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">During hospitalization, 44 patients (25.1%) developed AKI, although only 14 (8%) corresponded to more advanced stages. These 14 patients had significantly higher Gal-3 levels at admission, which remained a predictor of AKI after the multivariate adjustment by other predictors and by baseline renal function.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">High Gal-3 levels at admission are associated with a higher risk of AKI during hospitalization for decompensated HF.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En descompensaciones por insuficiencia cardiaca (IC), tanto el daño renal agudo (DRA) como los niveles elevados de galectina-3 (Gal-3) se han asociado con una peor evolución. Los niveles plasmáticos de Gal-3 se ven influidos por la función renal; sin embargo, el posible papel de la Gal-3 como predictor de DRA no está establecido.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se midieron las concentraciones de Gal-3 al ingreso en 175 pacientes hospitalizados por IC y se registró la aparición de DRA según los criterios analíticos RIFLE.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Durante el ingreso, 44 pacientes (25,1%) desarrollaron DRA, aunque solo 14 (8%) correspondían a los estadios más avanzados, siendo en estos los niveles de Gal-3 al ingreso significativamente mayores, permaneciendo como predictor de DRA tras el ajuste multivariado por otras variables predictoras y por función renal basal.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los valores elevados de Gal-3 al ingreso se asocian a mayor riesgo de DRA durante la hospitalización por IC descompensada.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sanchez-Serna J, Martinez-Villanueva M, Hernández-Vicente Á, Asensio-Lopez MC, Noguera JA, Pascual-Figal DA. Galectina-3 como biomarcador de riesgo de daño renal agudo en pacientes con insuficiencia cardiaca descompensada. Rev Clin Esp. 2019;219:315–319.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1068 "Ancho" => 2489 "Tamanyo" => 149398 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Galectin-3 levels according to acute kidney injury stage.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: 95% CI, 95% confidence interval; AHT, arterial hypertension; eGFR, estimated glomerular filtration rate; LVEF, left ventricular ejection fraction; NT-proBNP, amino-terminal fragment of the brain natriuretic peptide; OR, odds ratio.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Univariate analysis</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Multivariate analysis</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gal-3, ng/mL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.03 (1.01–1.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.02 (1.01–1.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.021 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NT-proBNP, pg/mL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.01 (1–1.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.99–1.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.132 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LVEF <40% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.06 (1.22–13.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.022 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.74 (0.79–17.67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.096 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.03 (0.97–1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.270 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.05 (0.96–1.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.300 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.92 (0.58–6.39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.79 (0.17–3.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.758 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AHT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1 (0.39–4.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.471 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.65 (0.32–41.84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.298 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline eGFR, mL/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.97 (0.95–0.99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.99 (0.96–1.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.419 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2092914.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Risk analysis for predicting acute kidney injury.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The regulation of inflammation by galectin-3" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N.C. 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