scholarly journals THE ROLE OF NEW BIOMARKERS IN ACUTE KIDNEY INJURY DETECTING IN CRITICAL CONDITION PATIENTS

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
V Sharipova ◽  
N Berdiev ◽  
O Lutfullaev ◽  
A Mikhliev
Keyword(s):  
Acute Kidney Injury ◽  
Urine Volume ◽  
Kidney Injury ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Nitrogenous Compounds ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
New Biomarkers ◽  
Sudden Decrease ◽  
Neutrophil Gelatinase

Acute kidney injury is a polyetiologic syndrome that is a sudden decrease in kidney function over several days or weeks, causing the accumulation of nitrogenous compounds in the blood, with or without a decrease in urine output. Acute kidney injury is common in hospitalized patients and is associated with increased morbidity, mortality, and financial costs. Currently, acute kidney injury is diagnosed after the onset of symptoms; Available diagnostic tests (presence of creatinine in the blood, microscopy of urine, urine volume) have shortcomings in identifying subclinical acute kidney injury. The lack of therapeutic strategies leads to the fact that the treatment of acute kidney injury is carried out with the help of supportive therapies. Early acute kidney injury detection is essential to minimize damage. Experimental and clinical studies have identified a new biomarker that contribute to the earlier diagnosis of acute kidney injury. With their help, it can be determined that patients are at risk of acute kidney damage. In this review, the authors describe some of the most promising new AKI biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule (KIM-1), interleukin-18 (IL18), tissue inhibitor of metalloproteinase-2 (TIMP-2), protein -7, which binds insulin-like growth factor (IGFBP7)).

scholarly journals Beta-Trace Protein as a Potential Marker of Acute Kidney Injury: A Pilot Study

2021 ◽  
pp. 1-11
Author(s):  
Katrien Leyssens ◽  
Niels Van Regenmortel ◽  
Ella Roelant ◽  
Khadija Guerti ◽  
Marie Madeleine Couttenye ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Roc Analysis ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Great Accuracy ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Potential Marker ◽  
Significant Difference ◽  
Neutrophil Gelatinase

<b><i>Introduction:</i></b> Acute kidney injury (AKI) is a frequent complication among patients in the intensive care unit (ICU). The limitations of serum Cr (sCr) in timely detecting AKI are well known. Beta-trace protein (BTP) is emerging as a novel endogenous glomerular filtration rate marker. The aim of this study was to explore the role of BTP as a marker of AKI. <b><i>Methods:</i></b> Patients admitted to the ICU undergoing surgery were included. BTP, sCr, Cystatin C (CysC), and neutrophil gelatinase-associated lipocalin (NGAL) were measured preoperatively, postoperatively (post-op), and at the first (D1) and second (D2) post-op day. AKI was defined as an increase of sCr to ≥1.5-fold from baseline within 2 days after surgery. <b><i>Results:</i></b> Of the 52 patients studied, 10 patients (19%) developed AKI. Patients with AKI were older (69.6 ± 10.7 vs. 58.1 ± 16.7 years, <i>p</i> = 0.043) and had a longer length of ICU stay (13 [IQR 6–49] vs. 6 [IQR 5–8] days, <i>p</i> = 0.032). Between the 2 groups, the evolution of BTP, sCr, CysC, and NGAL over time differed significantly, with overall higher values in the AKI group. ROC analysis for the detection of AKI within 2 days after surgery showed a great accuracy for BTP. The area under the curve (AUC) for BTP post-op; D1; and D2 was, respectively, 0.869 ± 0.049; 0.938 ± 0.035; and 0.943 ± 0.032. The discriminative power of a BTP measurement on D1 was superior in detecting AKI compared to NGAL (adjusted <i>p</i> value = 0.027). We could not detect a significant difference between the AUCs of other biomarkers (NGAL, sCr, and CysC). <b><i>Conclusion:</i></b> Serum BTP is a promising marker for diagnosing AKI in ICU patients undergoing surgery.

scholarly journals Subclinical Contrast-Induced Acute Kidney Injury in Patients Undergoing Cerebral Computed Tomography

2020 ◽  
Vol 10 (2) ◽  
pp. 125-136 ◽  
Author(s):  
Andrea Breglia ◽  
Ilaria Godi ◽  
Grazia Maria Virzì ◽  
Gabriele Guglielmetti ◽  
Giuseppe Iannucci ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Contrast Medium ◽  
Kidney Injury ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Increased Risk ◽  
Cerebral Computed Tomography ◽  
Novel Biomarkers ◽  
Neutrophil Gelatinase

Introduction: The nephrotoxicity of modern contrast media remains controversial. Novel biomarkers of kidney damage may help in identifying a subclinical structural renal injury not revealed by widely used markers of kidney function. Objective: The aim of this study was to investigate clinical (contrast-induced acute kidney injury [CI-AKI]) and subclinical CI-AKI (SCI-AKI) after intra-arterial administration of Iodixanol and Iopamidol in patients with an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2. Methods: This is a prospective observational monocentric study. Urinary sample was collected at 4–8 h after contrast medium exposure to measure neutrophil gelatinase associated lipocalin (NGAL) and the product tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 ([TIMP-2] × [IGFBP7]), while blood samples were collected at 24 and 48 h after exposure to measure serum creatinine. Results: One hundred patients were enrolled, of whom 53 were exposed to Iodixanol and 47 to Iopamidol. Patients in Iodixanol and Iopamidol groups were comparable in terms of demographics, pre-procedural and procedural data. No patient developed CI-AKI according KDIGO criteria, while 13 patients reported SCI-AKI after exposure to iodine-based medium contrast (3 patients in Iodixanol group and 10 patients in Iopamidol group), defined by positive results of NGAL and/or [TIMP-2] × [IGFBP7]. A positive correlation was found between NGAL and [TIMP-2] × [IGFBP7] in the analysed population (Spearman’s rho 0.49, p < 0.001). In logistic regression analysis, Iopamidol exposure showed higher risk for SCI-AKI compared to Iodixanol (OR 4.5 [95% CI 1.16–17.52], p = 0.030), even after controlling for eGFR and volume of contrast medium used. Conclusions: This study showed that intra-arterial modern contrast media administration may have a nephrotoxic effect in a population without pre-existing chronic kidney disease. Further investigations on larger scale are warranted to confirm if Iopamidol exposed patients to increased risk of SCI-AKI compared to Iodixanol.

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