#452 Plasma extracellular cold-inducible RNA-binding protein (eCIRP) is associated with acute kidney injury in patients after cardiac arrest

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Abstract Background and Aims Acute kidney injury (AKI) is a predictor of mortality after a resuscitated cardiac arrest (CA). We aimed to evaluate plasma extracellular cold-induced RNA-binding protein (eCIRP), a pro-inflammatory alarmin released in metabolic stress situations, in predicting AKI after CA. Method We retrospectively analyzed data of patients prospectively followed-up after their admission to a tertiary hospital following CA. eCIRP levels were assessed using ELISA on frozen plasma samples from admission to day 3. We considered the maximum eCIRP value within the first 24 h (eCIRPmax) for subsequent statistical analyses. Results We included 153 patients with a median age of 64 years and 91 (59%) were male. The mortality rate was 77%, and AKI occurred in 47% of the patients. Plasma eCIRP was higher in patients who developed AKI (diagnosed after day 1) than in those who did not, regardless of the timing of measurement from admission to day 3, or when using eCIRPmax (Fig. 1A). Plasma eCIRPmax was higher in patients who died than in survivors (Fig. 1B). The AUC of the ROC curve for eCIRPmax in diagnosing AKI was 0.745 (95% CI 0.651–0.840; Fig. 1C). In multiple regression analyses, plasma eCIRPmax remained associated with AKI when accounting for covariates related to patient demographics (Model 1; P < 0.001), admission severity (Model 2; P = 0.018), CA characteristics (Model 3; P < 0.001), or all of them (Model 1 + 2 + 3; P = 0.006). Conclusion Plasma eCIRP measured in the first 24 h after CA is an independent predictor of AKI and has promising value as a biomarker.

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