1
|
Berezin AE, Berezina TA, Hoppe UC, Lichtenauer M, Berezin AA. An overview of circulating and urinary biomarkers capable of predicting the transition of acute kidney injury to chronic kidney disease. Expert Rev Mol Diagn 2024:1-21. [PMID: 39007888 DOI: 10.1080/14737159.2024.2379355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION Acute kidney injury (AKI) defined by a substantial decrease in kidney function within hours to days and is often irreversible with higher risk to chronic kidney disease (CKD) transition. AREAS COVERED The authors discuss the diagnostic and predictive utilities of serum and urinary biomarkers on AKI and on the risk of AKI-to-CKD progression. The authors focus on the relevant literature covering evidence of circulating and urinary biomarkers' capability to predict the transition of AKI to CKD. EXPERT OPINION Based on the different modalities of serum and urinary biomarkers, multiple biomarker panel seems to be potentially useful to distinguish between various types of AKI, to detect the severity and the risk of AKI progression, to predict the clinical outcome and evaluate response to the therapy. Serum/urinary neutrophil gelatinase-associated lipocalin (NGAL), serum/urinary uromodulin, serum extracellular high mobility group box-1 (HMGB-1), serum cystatin C and urinary liver-type fatty acid-binding protein (L-FABP) were the most effective in the prediction of AKI-to-CKD transition regardless of etiology and the presence of critical state in patients. The current clinical evidence on the risk assessments of AKI progression is mainly based on the utility of combination of functional, injury and stress biomarkers, mainly NGAL, L-FABP, HMGB-1 and cystatin C.
Collapse
Affiliation(s)
- Alexander E Berezin
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Tetiana A Berezina
- Department of Internal Medicine & Nephrology, VitaCenter, Zaporozhye, Ukraine
| | - Uta C Hoppe
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | | |
Collapse
|
2
|
Sakkanan NV, Swaminathan S, Bidkar PU, Vairappan B, Sathiaprabhu A, Dey A. Comparison of the efficacy of 0.9% normal saline with balanced crystalloid (Plasmalyte) in maintaining the metabolic profile in head injury patients undergoing evacuation of acute subdural haematoma - A randomised controlled trial. Indian J Anaesth 2024; 68:553-559. [PMID: 38903257 PMCID: PMC11186531 DOI: 10.4103/ija.ija_1160_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 06/22/2024] Open
Abstract
Background and Aims The choice of intravenous fluids is important in patients with traumatic brain injury (TBI), where large volumes may be required for resuscitation. Our study aimed to compare 0.9% normal saline (NS) with balanced crystalloid (Plasmalyte) in TBI patients in terms of metabolic and coagulation profile, brain relaxation score (BRS) and renal functions using serum urea, creatinine and urinary tissue inhibitor of metalloproteinases-2* insulin-like growth factor binding protein-7, [TIMP-2]*[IGFBP7], value to assess the risk of acute kidney injury. Methods This randomised controlled trial on 90 TBI patients undergoing emergency craniotomy and subdural haematoma evacuation was conducted in a tertiary care institute. The patients were randomised to receive either NS (Group NS) or Plasmalyte (Group P) as the intraoperative maintenance fluid. The primary outcome measures included the potential of hydrogen (pH), base excess (BE) and chloride values from an arterial blood gas. The secondary outcomes were the coagulation profile, BRS and urinary [TIMP-2]*[IGFBP7]. The two groups' metabolic profile differences were analysed using two-way repeated analysis of variance. BRS was analysed using the Mann-Whitney U test. A P value < 0.05 was considered to be statistically significant. Results The pH and chloride values were significantly higher, and the BE values were significantly lower in Group P compared to Group NS (P < 0.001). Brain relaxation and coagulation profiles were comparable between the two groups. Serum creatinine (P = 0.002) and urinary [TIMP-2]*[IGFBP7] (P = 0.042) were significantly higher in the NS group. Conclusion Plasmalyte maintains a more favourable metabolic profile than NS in TBI patients without affecting brain relaxation adversely.
Collapse
Affiliation(s)
- Naveen Vivek Sakkanan
- Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Srinivasan Swaminathan
- Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Prasanna Udupi Bidkar
- Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - A Sathiaprabhu
- Department of Neurosurgery, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India
| | - Ankita Dey
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bathinda, Punjab, India
| |
Collapse
|
3
|
Klimm W, Szamotulska K, Karwański M, Bartoszewicz Z, Witkowski W, Rozmyslowicz T, Niemczyk S. Tissue Inhibitors of Metalloproteinase 1 (TIMP-1) and 3 (TIMP-3) as New Markers of Acute Kidney Injury After Massive Burns. Med Sci Monit 2024; 30:e943500. [PMID: 38706186 PMCID: PMC11084814 DOI: 10.12659/msm.943500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/20/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a common and serious complication after massive burn injury. One of the postulated etiologies is destruction of the extracellular matrix of nephrons, caused by a local imbalance between matrix metalloproteinases (MMPs) and specific inhibitors. The aim of this study was to analyze the dynamics of tissue inhibitors of metalloproteinases (TIMPs) during the first 5 days after massive thermal injury and the relationship with the risk of AKI. MATERIAL AND METHODS Thirty-three adults (22 men, 11 women) with severe burns were enrolled in the study. The values of TIMPs 1 to 4 were measured in blood serum and urine using the multiplex Luminex system. The associations between TIMPs and the risk of AKI were analyzed by using the generalized linear mixed models for repeated measurements. RESULTS Significant changes in serum and urine activities of TIMPs were confirmed, especially during the first 2 days after burn injury. Almost half of patients presented renal problems during the study. Significant differences between values of TIMPs in AKI and non-AKI status were also observed. However, a significant relationship between concentration of TIMPs and risk of AKI was confirmed only for urine TIMP-1 and serum TIMP-3. CONCLUSIONS The evaluation of TIMPs in the early stage after burn injury has potential benefits. The important roles of urine TIMP-1 and serum TIMP-3, as novel markers of the risk of AKI development, were confirmed. Other parameters require further analysis.
Collapse
Affiliation(s)
- Wojciech Klimm
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland
| | - Marek Karwański
- Department of Applied Mathematics, University of Life Sciences, SGGW, Warsaw, Poland
| | - Zbigniew Bartoszewicz
- Department of Internal Diseases and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Witkowski
- Department of Burns, Plastic and Reconstructive Surgery, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Tomasz Rozmyslowicz
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stanisław Niemczyk
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| |
Collapse
|
4
|
Bufkin KB, Karim ZA, Silva J. Review of the limitations of current biomarkers in acute kidney injury clinical practices. SAGE Open Med 2024; 12:20503121241228446. [PMID: 38322582 PMCID: PMC10846001 DOI: 10.1177/20503121241228446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024] Open
Abstract
Acute kidney injury is a prevalent disease in hospitalized patients and is continuously increasing worldwide. Various efforts have been made to define and classify acute kidney injury to understand the progression of this disease. Furthermore, deviations from structure and kidney function and the current diagnostic guidelines are not adequately placed due to baseline serum creatinine values, which are rarely known and estimated based on glomerular function rate, resulting in misclassification of acute kidney injury staging. Hence, the current guidelines are still developing to improve and understand the clinical implications of risk factors and earlier predictive biomarkers of acute kidney injury. Yet, studies have indicated disadvantages and limitations with the current acute kidney injury biomarkers, including lack of sensitivity and specificity. Therefore, the present narrative review brings together the most current evidenced-based practice and literature associated with the limitations of the gold standard for acute kidney injury diagnoses, the need for novel acute kidney injury biomarkers, and the process for biomarkers to be qualified for diagnostic use under the following sections and themes. The introduction section situates the anatomy and normal and abnormal kidney functions related to acute kidney injury disorders. Guidelines in providing acute kidney injury definitions and classification are then considered, followed by a discussion of the disadvantages of standard markers used to diagnose acute kidney injury. Characteristics of an ideal acute kidney injury biomarker are discussed concerning sensitivity, specificity, and anatomic location of injury. A particular focus on the role and function of emerging biomarkers is discussed in relation to their applications and significance to the prognosis and severity of acute kidney injury. Findings show emerging markers are early indicators of acute kidney injury prediction in different clinical settings. Finally, the process required for a biomarker to be applied for diagnostic use is explained.
Collapse
Affiliation(s)
- Kendra B Bufkin
- Department of Interdisciplinary Health Science, College of Allied Health Science, Augusta University, Augusta, GA, USA
| | - Zubair A Karim
- Department of Interdisciplinary Health Science, College of Allied Health Science, Augusta University, Augusta, GA, USA
| | - Jeane Silva
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA
| |
Collapse
|
5
|
Abouhadid MA, Gawad TAA, Gebaly HHE, Abdallah AA, Refay ASE, Helmy NM, Allam AM. Urinary tissue inhibitor of metalloproteinase-2 as an early predictor for acute kidney injury in critically ill children. Int J Health Sci (Qassim) 2023; 17:22-28. [PMID: 37416842 PMCID: PMC10321466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Objectives Acute kidney injury (AKI) is one of the most devastating complications of critical illness in children. Serum creatinine (Scr) is considered the gold standard for AKI diagnosis yet noted to be late and inaccurate. This raises the need for an early and accurate biochemical parameter for the early detection of AKI. This research aimed to explore the role of urinary tissue inhibitor metalloproteinase 2 (TIMP-2) in the early prediction of AKI, compared to standard biomarkers, in critically ill children admitted to pediatric intensive care unit (PICU). Urine TIMP2 was previously explored in multiple adult studies and showed promising results; however, the study of its role in pediatric population was limited. Methods This study was a prospective cohort study including 42 critically ill children who are at increased risk of AKI. Cases were recruited from the PICU in the Children's Hospital of Ain-Shams University, Cairo - Egypt over 10 months' duration. Urine samples were collected to measure urinary TIMP-2 and blood samples were taken to measure the levels of Scr, creatinine clearance, and blood urea nitrogen. Urine output in 24 h was also calculated. Results Urinary TIMP-2 showed considerably higher levels in AKI compared to non-AKI patients as early as day 1, whereas increased levels of Scr and decreased urine output were noticed later (day 3 and day 5, respectively). A notable correlation existed between TIMP-2 at day 1 and creatinine at day 3. Conclusion The present study revealed that urinary TIMP-2 could have an important role in the early prediction of AKI before the increase in Scr and more deterioration in kidney functions.
Collapse
Affiliation(s)
- Maha A. Abouhadid
- Department of Child Health, Primary: National Research Centre, Giza, Egypt
- Department of Paediatrics, Arrowe Park Hospital, Wirral, UK
| | - Tarek A. Abdel Gawad
- Children’s Hospital, Ain-Shams University, Paediatric Intensive Care Unit, Cairo, Egypt
| | | | - Azza A. Abdallah
- Department of Child Health, National Research Centre, Giza, Egypt
| | | | - Neveen M. Helmy
- Department of Clinical Pathology, National Research Centre, Giza, Egypt
| | - Ahmad M. Allam
- Children’s Hospital, Ain-Shams University, Paediatric Intensive Care Unit, Cairo, Egypt
| |
Collapse
|
6
|
La AM, Gunning S, Trevino SA, Kunczt A, Forni LG, Swamy V, Zarbock A, Groboske S, Leung EKY, Yeo KTJ, Koyner JL. Real-World Use of AKI Biomarkers: A Quality Improvement Project Using Urinary Tissue Inhibitor Metalloprotease-2 and Insulin-Like Growth Factor Binding Protein 7 ([TIMP-2]*[IGFBP7]). Am J Nephrol 2023; 54:281-290. [PMID: 37356428 DOI: 10.1159/000531641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Novel urinary biomarkers, including tissue inhibitor metalloprotease-2 and insulin-like growth factor binding protein 7 ([TIMP-2]*[IGFBP7]), have been developed to identify patients at risk for acute kidney injury (AKI). We investigated the "real-world" clinical utility of [TIMP-2]*[IGFBP7] in preventing AKI. METHODS We performed a before and after single-center quality improvement study of intensive care unit (ICU) patients at risk for severe (KDIGO stage 2 or 3) AKI. In the prospective cohort, ICU providers were allowed to order [TIMP-2]*[IGFBP7] for patients at their discretion, then offered AKI practice recommendations based on the results. Outcomes were compared to a historical cohort in which biomarker values were not reported to clinical teams. RESULTS There was no difference in 7-day progression to severe AKI between the prospective (n = 116) and historical cohorts (n = 63) when [TIMP-2]*[IGFBP7] ≥0.3 (24 [28%] versus 8 [21%], p = 0.38) despite more stage 1 AKI at time of biomarker measurement in the prospective cohort (58 [67%] versus 9 [23%], p < 0.001). In the prospective cohort, patients with higher [TIMP-2]*[IGFBP7] values were more likely to receive a nephrology consult. Early consultation (within 24 h of biomarker measurement, n = 20) had a nonsignificant trend toward net negative volume balance (-1,787 mL [6,716 mL] versus + 4,974 mL [15,540 mL]) and more diuretic use (19 [95%] versus 8 [80%]) and was associated with less severe AKI (9 [45%] versus 10 [100%], p = 0.004) and inpatient dialysis (2 [10%] versus 7 [70%], p = 0.002) compared to delayed consultation (n = 10). CONCLUSIONS Despite the prospective cohort having more preexisting stage 1 AKI, there were equal rates of progression to severe AKI in the prospective and historical cohorts. In the setting of [TIMP-2]*[IGFBP7] reporting, there were more nephrology consults in response to elevated biomarker levels. Early nephrology consultation resulted in improved volume balance and favorable outcomes compared to delayed consultation.
Collapse
Affiliation(s)
- Ashley M La
- Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Samantha Gunning
- Section of Nephrology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Sharon A Trevino
- Section of Nephrology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Alissa Kunczt
- Section of Nephrology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Lui G Forni
- Department of Intensive Care Medicine, Royal Surrey Hospital and Faculty of Health Sciences, University of Surrey, Guildford, UK
| | - Varsha Swamy
- Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Alexander Zarbock
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, University Hospital Munster, Munster, Germany
- Outcomes Research Consortium, Cleveland, Ohio, USA
| | - Sarah Groboske
- Section of Clinical Chemistry, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Edward K Y Leung
- Section of Clinical Chemistry, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Kiang-Teck J Yeo
- Section of Clinical Chemistry, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Jay L Koyner
- Section of Nephrology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
7
|
Mapuskar KA, Vasquez-Martinez G, Mayoral-Andrade G, Tomanek-Chalkley A, Zepeda-Orozco D, Allen BG. Mitochondrial Oxidative Metabolism: An Emerging Therapeutic Target to Improve CKD Outcomes. Biomedicines 2023; 11:1573. [PMID: 37371668 DOI: 10.3390/biomedicines11061573] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Chronic kidney disease (CKD) predisposes one toward end-stage renal disease (ESRD) and its associated morbidity and mortality. Significant metabolic perturbations in conjunction with alterations in redox status during CKD may induce increased production of reactive oxygen species (ROS), including superoxide (O2●-) and hydrogen peroxide (H2O2). Increased O2●- and H2O2 may contribute to the overall progression of renal injury as well as catalyze the onset of comorbidities. In this review, we discuss the role of mitochondrial oxidative metabolism in the pathology of CKD and the recent developments in treating CKD progression specifically targeted to the mitochondria. Recently published results from a Phase 2b clinical trial by our group as well as recently released data from a ROMAN: Phase 3 trial (NCT03689712) suggest avasopasem manganese (AVA) may protect kidneys from cisplatin-induced CKD. Several antioxidants are under investigation to protect normal tissues from cancer-therapy-associated injury. Although many of these antioxidants demonstrate efficacy in pre-clinical models, clinically relevant novel compounds that reduce the severity of AKI and delay the progression to CKD are needed to reduce the burden of kidney disease. In this review, we focus on the various metabolic pathways in the kidney, discuss the role of mitochondrial metabolism in kidney disease, and the general involvement of mitochondrial oxidative metabolism in CKD progression. Furthermore, we present up-to-date literature on utilizing targets of mitochondrial metabolism to delay the pathology of CKD in pre-clinical and clinical models. Finally, we discuss the current clinical trials that target the mitochondria that could potentially be instrumental in advancing the clinical exploration and prevention of CKD.
Collapse
Affiliation(s)
- Kranti A Mapuskar
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| | - Gabriela Vasquez-Martinez
- Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Gabriel Mayoral-Andrade
- Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Ann Tomanek-Chalkley
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| | - Diana Zepeda-Orozco
- Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
- Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, OH 43210, USA
| | - Bryan G Allen
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| |
Collapse
|
8
|
Dutta A, Saha S, Bahl A, Mittal A, Basak T. A comprehensive review of acute cardio-renal syndrome: need for novel biomarkers. Front Pharmacol 2023; 14:1152055. [PMID: 37288107 PMCID: PMC10242013 DOI: 10.3389/fphar.2023.1152055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
Cardiorenal syndrome represents a wide-spectrum disorder involving the heart and kidneys as the primary affected organs. India has an increasingly high burden of acute CRS, coinciding with the rise in global statistics. Up to 2022, approximately 46.1% of all cardiorenal patients have been diagnosed with acute CRS in India. Acute CRS involves a sudden deterioration of kidney functionalities, referred to as acute kidney injury (AKI) in acute heart failure patients. The pathophysiology of CRS involves hyperactivation of the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS) following acute myocardial stress. The pathological phenotype of acute CRS is associated with perturbed inflammatory, cellular, and neurohormonal markers in circulation. These complications increase the risk of mortality in clinically diagnosed acute CRS patients, making it a worldwide healthcare burden. Hence, effective diagnosis and early prevention are crucial to prevent the progression of CRS in AHF patients. Present biomarkers, such as serum creatinine (sCr), cystatin C (CysC), glomerular filtration rate (GFR), blood urea nitrogen (BUN), serum and/or urine neutrophil gelatinase-associated lipocalin (NGAL), B-type natriuretic peptide (BNP), and NT-proBNP, are clinically used to diagnose AKI stages in CRS patients but are limitedly sensitive to the early detection of the pathology. Therefore, the need for protein biomarkers is emerging for early intervention in CRS progression. Here, we summarized the cardio-renal nexus in acute CRS, with an emphasis on the present clinicopathological biomarkers and their limitations. The objective of this review is to highlight the need for novel proteomic biomarkers that will curb the burgeoning concern and direct future research trials.
Collapse
Affiliation(s)
- Abhi Dutta
- School of Biosciences and Bioengineering, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, India
- BioX Center, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, India
| | - Shubham Saha
- School of Biosciences and Bioengineering, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, India
- BioX Center, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, India
| | - Ajay Bahl
- Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anupam Mittal
- Department of Translational and Regenerative Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Trayambak Basak
- School of Biosciences and Bioengineering, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, India
- BioX Center, Indian Institute of Technology (IIT)-Mandi, Mandi, Himachal Pradesh, India
| |
Collapse
|
9
|
Huang F, Zeng Y, Lv L, Chen Y, Yan Y, Luo L, Pan R, Jiang J, Wei X. Predictive value of urinary cell cycle arrest biomarkers for all cause-acute kidney injury: a meta-analysis. Sci Rep 2023; 13:6037. [PMID: 37055509 PMCID: PMC10102152 DOI: 10.1038/s41598-023-33233-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
The cell cycle arrest markers tissue inhibitor metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been identified as potential biomarkers of acute kidney injury (AKI) in critically ill adults in intensive care units and cardiac surgery-associated AKI (CSA-AKI). However, the clinical impact on all-cause AKI remains unclear. Here, we report a meta-analysis performed to evaluate the predictive value of this biomarker for all-cause AKI. The PubMed, Cochrane, and EMBASE databases were systematically searched up to April 1, 2022. We used the Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. We extracted useful information from these studies and calculated the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). Twenty studies with 3625 patients were included in the meta-analysis. The estimated sensitivity of urinary [TIMP-2] × [IGFBP7] in the diagnosis of all-cause AKI was 0.79 (95% CI 0.72, 0.84), and the specificity was 0.70 (95% CI 0.62, 0.76). The value of urine [TIMP-2] × [IGFBP7] in the early diagnosis of AKI was assessed using a random effects model. The pooled positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 2.6 (95% CI 2.1, 3.3), 0.31 (95% CI 0.23, 0.40), and 8 (95% CI 6, 13), respectively. The AUROC was 0.81 (95% CI 0.78-0.84). No significant publication bias was observed in eligible studies. Subgroup analysis indicated that the diagnostic value was related to the severity of AKI, time measurement, and clinical setting. This study shows that urinary [TIMP-2] × [IGFBP7] is a reliable effective predictive test for all cause-AKI. However, whether and how urinary [TIMP-2] × [IGFBP7] can be used in clinical diagnosis still requires further research and clinical trials.
Collapse
Affiliation(s)
- Feng Huang
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Nanchang University, Nanchang, 330006, China
| | - Yan Zeng
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Linghai Lv
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Shangrao Guangxin District People's Hospital, Shangrao, 334100, Jiangxi, China
| | - Yaoyao Chen
- Nanchang University, Nanchang, 330006, China
| | - Yan Yan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Laimin Luo
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Rong Pan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Nanchang University, Nanchang, 330006, China
| | - Jiaming Jiang
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Nanchang University, Nanchang, 330006, China
| | - Xin Wei
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
| |
Collapse
|
10
|
Mahran MMA, Sabry Ahmed AM, Aly Mohamed AY, Khalifa Elsayed AF. Early prediction of acute kidney injury with cell cycle arrest biomarkers using plethesmography directed fluid management in major abdominal surgery. EGYPTIAN JOURNAL OF ANAESTHESIA 2022. [DOI: 10.1080/11101849.2022.2096302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
11
|
Burn-Induced Acute Kidney Injury-Two-Lane Road: From Molecular to Clinical Aspects. Int J Mol Sci 2022; 23:ijms23158712. [PMID: 35955846 PMCID: PMC9368898 DOI: 10.3390/ijms23158712] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/19/2022] [Accepted: 08/02/2022] [Indexed: 12/29/2022] Open
Abstract
Severe burn injuries lead to acute kidney injury (AKI) development, increasing the mortality risk up to 28-100%. In addition, there is an increase in hospitalization days and complications appearance. Various factors are responsible for acute or late AKI debut, like hypovolemia, important inflammatory response, excessive load of denatured proteins, sepsis, and severe organic dysfunction. The main measure to improve the prognosis of these patients is rapidly recognizing this condition and reversing the underlying events. For this reason, different renal biomarkers have been studied over the years for early identification of burn-induced AKI, like neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinase-2 (TIMP-2), interleukin-18 (IL-18), and insulin-like growth factor-binding protein 7 (IGFBP7). The fundamental purpose of these studies is to find a way to recognize and prevent acute renal injury progression early in order to decrease the risk of mortality and chronic kidney disease (CKD) onset.
Collapse
|