Translational Research Investigating Biomarker Endpoints (TRIBE)

The Translational Research Investigating Biomarker Endpoints (TRIBE) consortium aims to improve the outcomes and safety of cardiac surgery. This multicenter prospective observational study is sponsored by the National Heart, Lung, and Blood Institute to investigate novel biomarkers in the detection of early AKI after major cardiac surgery. The main objective of the study is to determine whether the novel biomarkers can be used as diagnostic tests to improve pre-operative and post-operative risk-stratification of acute kidney injury (AKI). Nine North American sites are participating in this projects. Over 3,000 patients, both adult and children, undergoing cardiac surgery were enrolled. Blood and urine specimens were collected preoperatively and daily during the first 5 days of hospitalization. Some key results from this study are given below:

1. Kidney injury biomarkers peaked earlier than serum creatinine and were associated with AKI.

   

   Parikh CR, Devarajan P, Zappitelli M, Sint K, Thiessen-Philbrook H, Li S, Kim RW, Koyner JL, Coca SG, Edelstein CL, Shlipak MG, Garg AX, Krawczeski CD. Postoperative biomarkers predict acute kidney injury and poor outcomes after adult cardiac surgery. J Am Soc Nephrol 2011; 22(9): 1748-1757.

2. Mortality Rates approx. 3 years after cardiac surgery increased monotonically by tertile of urinary biomarkers in the patients with and without AKI during index hospitalization. The mortality rate in the highest tertile of urinary biomarkers of kidney injury in those without clinical AKI approximated the mortality rate in the lowest tertile of biomarkers in those with clinical AKI (except for L-FABP).

   

   Coca,S.G.; Garg,A.X.; Thiessen-Philbrook,H.; Koyner,J.L.; Patel,U.D.; Krumholz,H.M.; Shlipak,M.G.; Parikh,C.R. Urinary Biomarkers of AKI and Mortality 3 Years after Cardiac Surgery. J Am Soc Nephrol 2014; 25(5):1063-71.

3. Clinical AKI at the time of cardiac surgery is indicative of concurrent cardiovascular stress rather than an independent renal pathway for long-term adverse cardiovascular events.

   

   Coca,S.G.; Garg,A.X.; Thiessen-Philbrook,H.; Koyner,J.L.; Patel,U.D.; Krumholz,H.M.; Shlipak,M.G.; Parikh,C.R. Urinary Biomarkers of AKI and Mortality 3 Years after Cardiac Surgery. J Am Soc Nephrol 2014; 25(5):1063-71.

Funding information for this project

The TRIBE-AKI Consortium is supported by the NIH/NHLBI (R01HL085757, “Novel Biomarkers in Cardiac Surgery to Detect Acute Kidney Injury”)

PubMed

Biomarker Consortium in Acute Kidney Injury (TRIBE-AKI)