Potential role of imaging for assessing acute pancreatitis-induced acute kidney injury

Acute kidney injury (AKI) is a common complication of acute pancreatitis (AP) that is associated with increased mortality. Conventional assessment of AKI is based on changes in serum creatinine concentration and urinary output. However, these examinations have limited accuracy and sensitivity for the diagnosis of early-stage AKI. This review summarizes current evidence on the use of advanced imaging approaches and artificial intelligence (AI) for the early prediction and diagnosis of AKI in patients with AP. CT scores, CT post-processing technology, Doppler ultrasound, and AI technology provide increasingly valuable information for the diagnosis of AP-induced AKI. Magnetic resonance imaging (MRI) also has potential for the evaluation of AP-induced AKI. For the accurate diagnosis of early-stage AP-induced AKI, more studies are needed that use these new techniques and that use AI in combination with advanced imaging technologies.

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Renalase and Biomarkers of Contrast-Induced Acute Kidney Injury

Cardiorenal Medicine ◽

10.1159/000439117 ◽

2015 ◽

Vol 6 (1) ◽

pp. 25-36 ◽

Cited By ~ 10

Author(s):

Maciej T. Wybraniec ◽

Katarzyna Mizia-Stec

Keyword(s):

Acute Kidney Injury ◽

Renal Injury ◽

Amine Oxidase ◽

Kidney Injury ◽

Cardiorenal Syndrome ◽

Creatinine Concentration ◽

Invasive Cardiology ◽

Proximal Tubular ◽

Novel Biomarkers

Background: Contrast-induced acute kidney injury (CI-AKI) remains one of the crucial issues related to the development of invasive cardiology. The massive use of contrast media exposes patients to a great risk of contrast-induced nephropathy and chronic kidney disease development, and increases morbidity and mortality rates. The serum creatinine concentration does not allow for a timely and accurate CI-AKI diagnosis; hence numerous other biomarkers of renal injury have been proposed. Renalase, a novel catecholamine-metabolizing amine oxidase, is synthesized mainly in proximal tubular cells and secreted into urine and blood. It is primarily engaged in the degradation of circulating catecholamines. Notwithstanding its key role in blood pressure regulation, renalase remains a potential CI-AKI biomarker, which was shown to be markedly downregulated in the aftermath of renal injury. In this sense, renalase appears to be the first CI-AKI marker revealing an actual loss of renal function and indicating disease severity. Summary: The purpose of this review is to summarize the contemporary knowledge about the application of novel biomarkers of CI-AKI and to highlight the potential role of renalase as a functional marker of contrast-induced renal injury. Key Messages: Renalase may constitute a missing biochemical link in the mutual interplay between kidney and cardiac pathology known as the cardiorenal syndrome.

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The Predictive Role of New Markers in Early Diagnosis of Acute Kidney Injury in Patients with Acute Pancreatitis

Open Journal of Nephrology ◽

10.4236/ojneph.2020.103025 ◽

2020 ◽

Vol 10 (03) ◽

pp. 254-263

Author(s):

Ferdi Karagöz ◽

Dede Sit ◽

Aysegül Kirankaya ◽

Yasemin Aker Karagöz ◽

Arif Savas ◽

...

Keyword(s):

Acute Kidney Injury ◽

Acute Pancreatitis ◽

Early Diagnosis ◽

Kidney Injury ◽

Predictive Role

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Potential Prognostic Markers of Acute Kidney Injury in the Early Phase of Acute Pancreatitis

International Journal of Molecular Sciences ◽

10.3390/ijms20153714 ◽

2019 ◽

Vol 20 (15) ◽

pp. 3714 ◽

Cited By ~ 5

Author(s):

Justyna Wajda ◽

Paulina Dumnicka ◽

Małgorzata Maraj ◽

Piotr Ceranowicz ◽

Marek Kuźniewski ◽

...

Keyword(s):

Acute Kidney Injury ◽

Acute Pancreatitis ◽

Binding Protein ◽

Kidney Injury ◽

Current Evidence ◽

Serum Cystatin C ◽

Fatty Acid Binding ◽

Number Of Patients ◽

Kidney Injury Molecule 1 ◽

The Impact

Acute kidney injury (AKI) is a serious complication of acute pancreatitis (AP), which occurs in up to 70% of patients with severe AP and significantly increases the risk of mortality. At present, AKI is diagnosed based on dynamic increase in serum creatinine and decreased urine output; however, there is a need for earlier and more accurate biomarkers. The aim of the study was to review current evidence on the laboratory tests that were studied as the potential biomarkers of AKI in AP. We also briefly summarized the knowledge coming from the studies including sepsis or ICU patients since severe acute pancreatitis is associated with systemic inflammation and organ failure. Serum cystatin C and serum or urine NGAL have been shown to predict or diagnose AKI in AP; however, this evidence come from the single center studies of low number of patients. Other markers, such as urinary kidney injury molecule-1, cell cycle arrest biomarkers (tissue inhibitor metalloproteinase-2 and urine insulin-like growth factor-binding protein 7), interleukin-18, liver-type fatty acid-binding protein, or calprotectin have been studied in other populations suffering from systemic inflammatory states. In AP, the potential markers of AKI may be significantly influenced by either dehydration or inflammation, and the impact of these factors may be difficult to distinguish from kidney injury. The subject of AKI complicating AP is understudied. More studies are needed, for both exploratory (to choose the best markers) and clinical (to evaluate the diagnostic accuracy of the chosen markers in real clinical settings).

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