scholarly journals Acute Kidney Injury Biomarkers and Hydration Outcomes at the Boston Marathon

2022 ◽  
Vol 12 ◽  
Author(s):  
Whitley C. Atkins ◽  
Cory L. Butts ◽  
Melani R. Kelly ◽  
Chris Troyanos ◽  
R. Mark Laursen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Sex Differences ◽  
Kidney Injury ◽  
Urine Specific Gravity ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Time Points ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Boston Marathon ◽  
Neutrophil Gelatinase

The purpose of our field study was to investigate the effects of running the Boston Marathon on acute kidney injury (AKI) biomarkers. We hypothesized that biomarker values would be elevated immediately post-marathon but would resolve in the 24-h post-marathon. Secondarily, we sought to identify sex differences related to renal stress. Participants were 65 runners who completed the Boston Marathon (46 ± 9 years, 65.4 ± 10.8 kg). Urine samples were collected at three different time points (pre-marathon, post-marathon, and 24-h post-marathon). Blood samples were collected post-marathon and 24-h post-marathon. Urine specific gravity (USG) and AKI biomarkers were evaluated. Pre-marathon USG (1.012 ± 0.007) was significantly less than post-marathon (1.018 ± 0.008) and 24-h post-marathon (1.020 ± 0.009; P < 0.001). Male USG (1.024 ± 0.009) was significantly greater 24-h post-marathon than females (1.017 ± 0.008; P = 0.019). Urinary neutrophil gelatinase-associated lipocalin values were significantly greater over time (P < 0.001), and there was a main effect of sex with female urinary creatinine (UCr) greater than males at all three time points (P = 0.040). Post-marathonUCr (366.24 ± 295.16 mg/dl) was significantly greater than pre-marathon (206.65 ± 145.28.56 mg/dl; p < 0.001) and 24-h post-marathon was significantly lower than other time-points (93.90 ± 125.07 mg/dl; P < 0.001). FemaleUCr values were significantly greater than males 24-h post-marathon (P < 0.001). There was no difference in serum cystatin C (SCys) values post- or 24-h post-marathon (P = 0.178). Serum creatinine (SCr) significantly decreased between post-marathon and 24-h post-marathon, (P < 0.001). We can infer that the characteristics unique to the Boston Marathon may have attributed to prolonged elevations in AKI biomarkers. Sex differences were observed during the Boston Marathon warranting further investigation.

scholarly journals Evaluation of serum and urine neutrophil gelatinase-associated lipocalin and cystatin C as biomarkers of acute kidney injury in horses

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Natalia Siwińska ◽  
Agnieszka Żak ◽  
Urszula Pasławska
Keyword(s):  
At Risk ◽  
Acute Kidney Injury ◽  
Cystatin C ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase ◽  
Urinary Cystatin C

Abstract Introduction Diagnosis of acute kidney injury (AKI) in horses is difficult at the subclinical stage, due to nonspecific clinical signs. The aim of this study was to evaluate the concentrations of selected serum and urinary biomarkers in healthy horses, horses at risk of AKI, and those with clinical AKI. Material and Methods Thirty healthy horses, 30 horses at risk of AKI and 11 horses with clinical AKI and azotaemia were included in the study. Serum and urinary neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C were measured using commercially available enzyme immunoassay tests. Results The median and (in parentheses) first and third quartile concentrations of selected biomarkers in healthy horses, horses at risk of AKI and horses with AKI were respectively as follows: serum cystatin C – 0.25 (0.19–0.37), 0.23 (0.15–0.37) and 0.61 (0.37–1.13) mg/L; serum NGAL – 50.5 (38.8–58.8), 51.1 (40.4–66.9) and 98.1 (59.4–128.2) ng/mL; urinary NGAL – 20.7 (17.9–24.5), 32.3 (32.7–55.8) and 36.6 (26.8–89.9) ng/mL; and urinary cystatin C – 0.1 (0.07–0.13), 0.13 (0.1–0.2) and 0.34 (0.22–0.37) mg/L. There were significant differences in the concentration of all biomarkers between the healthy and AKI-affected horses. Conclusion Horses with AKI all had biomarker concentrations higher than the healthy horses. None of the biomarkers made azotaemia recognisable in all affected horses. The obtained results indicate the need to create a serum and urinary biomarker panel to detect AKI.

scholarly journals NGAL, albumin and cystatin C during cisplatin therapy

2020 ◽  
pp. 307-317
Author(s):  
B. Florova ◽  
D. Rajdl ◽  
J. Racek ◽  
O. Fiala ◽  
V. M. Matejka ◽  
...  
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Cumulative Effect ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Cisplatin Nephrotoxicity ◽  
Urine Albumin ◽  
Increased Risk ◽  
Neutrophil Gelatinase

Cisplatin is a commonly used chemotherapeutic drug. It is known for its nephrotoxic side effects with an increased risk of acute kidney injury. Finding of clinically feasible cisplatin nephrotoxicity markers is of importance. In our study, we compared neutrophil gelatinase-associated lipocalin (NGAL) in serum and urine, the estimated glomerular filtration rate (based on serum cystatin C) and urine albumin as markers of nephrotoxicity. The study involved 11 men and 9 women (mean ± SD age 58.2 ± 9.5 years) with different malignancies treated with cisplatin in four cycles of chemotherapy (I – IV). Samples 0 4 were taken before, immediately after, in 3, 6 and 24 hours after administering chemotherapy. We detected significant increase of ACR in Sample 2 (p=0.03) and decrease of eGFR in Sample 4 (p=0.03) up to 24 hours after cisplatin administration in the first chemotherapy cycle only. When cumulative effect of cisplatin was assessed, significantly increased values of urine albumin (vs cycle I) were found in Sample 0 (p=0.00058), 1 (p=0.00256), 2 (p=0.00456), 3 (p=0.00006) and 4 (p=0.00319) in cycles II to IV. We found a correlation between values of urine NGAL and urine albumin (r=0.68, p<0.0001). In conclusion, urine albumin was the only measured marker that consistently and statistically significantly increased after cisplatin containing chemotherapy cycles.

scholarly journals No Differences in Renal Function between Balanced 6% Hydroxyethyl Starch (130/0.4) and 5% Albumin for Volume Replacement Therapy in Patients Undergoing Cystectomy

2018 ◽  
Vol 128 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Tobias Kammerer ◽  
Florian Brettner ◽  
Sebastian Hilferink ◽  
Nikolai Hulde ◽  
Florian Klug ◽  
...  
Keyword(s):  
Renal Function ◽  
Hydroxyethyl Starch ◽  
Cystatin C ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Stage Renal Disease ◽  
End Stage ◽  
Neutrophil Gelatinase

Abstract Background The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0.4) on renal function and kidney injury. Methods One hundred urologic patients undergoing elective cystectomy were randomly assigned for this prospective, single-blinded, controlled study with two parallel groups to receive either albumin 5% or balanced hydroxyethyl starch 6% (130/0.4) as the only perioperative colloid. The primary endpoint was the ratio of serum cystatin C between the last visit at day 90 and the first preoperative visit. Secondary endpoints were estimated glomerular filtration rate and serum neutrophil gelatinase-associated lipocalin until the third postoperative day and risk, injury, failure, loss, and end-stage renal disease criteria at postoperative days 3 and 90. Results The median cystatin C ratio was 1.11 (interquartile range, 1.01 to 1.23) in the albumin and 1.08 (interquartile range, 1.00 to 1.20) in the hydroxyethyl starch group (median difference = 0.03; 95% CI, –0.09 to 0.08; P = 0.165). Also, there were no significant differences concerning serum cystatin C concentrations; estimated glomerular filtration rate; risk, injury, failure, loss, and end-stage renal disease criteria; and neutrophil gelatinase-associated lipocalin. Infusion requirements, transfusion rates, and perioperative hemodynamics were similar in both groups. Conclusions With respect to renal function and kidney injury, this study indicates that albumin 5% and balanced hydroxyethyl starch 6% have comparable safety profiles in noncritically ill patients undergoing major surgery.

Neutrophil gelatinase-associated lipocalin is a better biomarker than cystatin C for the prediction of imminent acute kidney injury in critically ill patients

2017 ◽  
Vol 55 (2) ◽  
pp. 190-197 ◽  
Author(s):  
Itir Yegenaga ◽  
Fatih Kamis ◽  
Canan Baydemir ◽  
Elizade Erdem ◽  
Koray Celebi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Cystatin C ◽  
Kidney Injury ◽  
Failure Criteria ◽  
Serum Cystatin C ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Aims The prevention of acute kidney injury can be lifesaving for the intensive care unit patients. However, conventional methods are not sufficient for the prediction of the risk of future acute kidney injury. In this study, the promising biomarker, neutrophil gelatinase-associated lipocalin, was compared with cystatin C as an indicator for the risk of future acute kidney injury. Methods One hundred and eighty-three adult patients without chronic kidney disease or renal replacement therapy were included in this study. The plasma and urine concentrations of neutrophil gelatinase-associated lipocalin and cystatin C were assessed on the second day after intensive care unit admission and were followed for seven days to monitor the development of acute kidney injury. Acute kidney injury diagnosis was based on the risk, injury, failure, loss, end-stage renal failure criteria. Results Thirty-four per cent of the patients had acute kidney injury; 17 patients who did not fulfil criteria at the beginning, developed acute kidney injury from days 3 to 7 after admission. The mean serum creatinine on admission did not significantly differ between this and control groups (0.72 ± 0.20 and 0.83 ± 0.21; P = 0.060); however, the serum and urinary neutrophil gelatinase-associated lipocalin concentrations on the second day were significantly different (median: 75.69 [54.18–91.18] and 123.68 [90.89–166.31], P = 0.001; and median: 17.60 [8.56–34.04] and 61.37 [24.59–96.63], P = 0.001). Notably, the 48-h serum cystatin C concentration did not differ. Conclusion Neutrophil gelatinase-associated lipocalin concentrations in the urine and serum on the second day of intensive care unit admission could be used to predict the development of acute kidney injury in the following three to seven days in the intensive care unit; however, the cystatin C concentration did not have predictive value.

scholarly journals Relationship between serum cystatin-C and urinary neutrophil gelatinase-associated lipocalin in septic children

2015 ◽  
Vol 55 (2) ◽  
pp. 83
Author(s):  
Jose Mandei ◽  
Elisa Iskandar ◽  
Adrian Umboh ◽  
Hesti Lestari
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Renal Diseases ◽  
P Value ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Good Nutrition ◽  
Neutrophil Gelatinase

Background Sepsis may lead to acute kidney injury (AKI)in patients treated in pediatric intensive care units (PICU).Currently, serum creatinine is used as a biomarker for thediagnosis of AKI. However, it is not a sensitive nor specifictest for AKI. The scarcity of biomarkers leads to delays in thediagnosis and treatment of AKI. Serum cystatin-C (sCys-C)and urinary neutrophil gelatinase-associated lipocalin (uNGAL)are potential biomarkers that look promising for early diagnosisof AKI.Objective To identify the relation of cystatin-C and NGAL inchildren with sepsis.Methods Serum cystatin-C and uNGAL were measured onseptic patients aged one month to 12 years. The diagnosesof sepsis were based on the 2002 International Pediatric SepsisConcensus. Patients were admitted to the Pediatric IntensiveDepartment of the Prof. Dr. R. D. Kandou Hospital, Manadofrom January to June 2013. The exclusion criteria werepatients with trauma, burns, severe dehydration, malnutrition,obesity, and history of renal diseases. Data analyses includeddescriptions for the characteristic data and Pearson’s coefficientcorrelation. A P value of 0.05 was considered to be statisticallysignificant. Data were analyzed with SPSS software for Windowsversion 21.Results Thirty-eight patients met the inclusion criteria, of whom23 were male and 15 were female. Their mean age was 22.6 (SD32.24) months, with overweight in 2 children, good nutrition in25 children, and under nutrition in 11 children. An increasedlevel of sCys-C was found in 22 children and an increased levelof uNGAL was found in 19 children. Serum cystatin-C wassignificantly correlated to uNGAL in septic patients (r=0.614;P<0.01).Conclusion There is a positively correlated relationship betweensCys C and uNGAL in septic children. Increased sCys C is associated with increased uNGAL in septic children.

Serum Cystatin C, Klotho, and Neutrophil Gelatinase-Associated Lipocalin in the Risk Prediction of Acute Kidney Injury after Acute Myocardial Infarction

2020 ◽  
Vol 10 (6) ◽  
pp. 374-381
Author(s):  
Yuanyuan Pei ◽  
Wen Chen ◽  
Xue Mao ◽  
Jihong Zhu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Kidney Injury ◽  
Serum Levels ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

<b><i>Background:</i></b> Patients with acute myocardial infarction (AMI) are at high risk for acute kidney injury (AKI). Novel biomarkers that can predict AKI after AMI may facilitate immediate interventions. Recently, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), and klotho have been established as novel AKI biomarkers. However, their effects have not been studied in patients presenting with AMI. In this study, we will measure the serum levels of these three biomarkers to find reliable biomarkers for early diagnosis of AKI in AMI patients. <b><i>Methods:</i></b> This prospective observational cohort study was conducted between May 2016 and November 2017. A total of 285 consecutive patients with AMI were enrolled. The study was approved by the institutional review board of Peking University People’s Hospital (No. 2016PHB 042-01). AKI was defined according to the KDIGO criteria in 2012. At admission, the clinical data of patients was collected and serum levels of several AKI biomarkers, including cystatin C, NGAL, and klotho, were measured by ELISA. The relationship between biomarker levels of AKI were analyzed and their discrimination performances were compared. <b><i>Results:</i></b> AKI incidence was 17.5% (50/285) during hospitalization. Compared to patients without AKI, the AKI group had higher mortality (20.0% vs. 0.4%,<i> p</i> &#x3c; 0.001) and tended to be older, had higher incidence of chronic kidney disease, severe cardiac function, more cardiac complications, larger doses of diuretics, and less use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker and statins. Moreover, AKI patients experienced an increase in serum cystatin C (3,709.2 ± 2,281.5 vs. 1,918.5 ± 1,140.6 ng/mL, <i>p</i> &#x3c; 0.001), NGAL (118.0 ± 70.3 vs. 91.8 ± 52.3 ng/mL, <i>p</i> = 0.003), and klotho (742.2 ± 497.4 vs. 470.3 ± 257.2 pg/mL, <i>p &#x3c;</i>0.001). Furthermore, the areas under the receiver operating curves demonstrated that serum cystatin C levels at admission had modest discriminative powers for predicting AKI after AMI compared with serum creatinine (0.899, 95% CI, 0.855–0.944 vs. 0.734, 95% CI, 0.649–0.819, <i>p &#x3c;</i>0.001). There was no difference between the discrimination performances of serum creatinine, NGAL, and klotho. <b><i>Conclusion:</i></b> Elevated cystatin C levels are associated with AKI in patients with AMI. This study provides reliable evidence that cystatin C levels may be superior to serum creatinine for predicting AKI after AMI at admission.

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