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Peng Y, Wang Q, Jin F, Tao T, Qin Q. Assessment of urine CCL2 as a potential diagnostic biomarker for acute kidney injury and septic acute kidney injury in intensive care unit patients. Ren Fail 2024; 46:2313171. [PMID: 38345000 PMCID: PMC10863526 DOI: 10.1080/0886022x.2024.2313171] [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: 07/28/2023] [Accepted: 01/27/2024] [Indexed: 02/15/2024] Open
Abstract
Acute kidney injury (AKI) is a prevalent and serious condition in the intensive care unit (ICU), associated with significant morbidity and mortality. Septic acute kidney injury (SAKI) contributes substantially to AKI cases in the ICU. However, current diagnostic methods have limitations, necessitating the exploration of novel biomarkers. In this study, we investigated the potential of plasma and urine CCL2 levels as diagnostic markers for AKI and SAKI in 216 ICU patients. Our findings revealed significant differences in plasma (p < 0.01) and urine CCL2 (p < 0.0001) levels between AKI and non-AKI patients in the ICU. Notably, urine CCL2 demonstrated promising predictive value for AKI, exhibiting high specificity and sensitivity (AUC = 0.8976; p < 0.0001). Furthermore, we observed higher urine CCL2 levels in SAKI compared to non-septic AKI (p < 0.001) and urine CCL2 could also differentiate SAKI from non-septic AKI (AUC = 0.7597; p < 0.0001). These results suggest that urine CCL2 levels hold promise as early biomarkers for AKI and SAKI, offering valuable insights for timely intervention and improved management of ICU patients.
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Affiliation(s)
- Yuan Peng
- Intensive Care Unit, The First People’s Hospital of Kunshan Affiliated to Jiangsu University, Kunshan, PR China
| | - Qin Wang
- Intensive Care Unit, The First People’s Hospital of Kunshan Affiliated to Jiangsu University, Kunshan, PR China
| | - Fang Jin
- Intensive Care Unit, The First People’s Hospital of Kunshan Affiliated to Jiangsu University, Kunshan, PR China
| | - Tao Tao
- Intensive Care Unit, The First People’s Hospital of Kunshan Affiliated to Jiangsu University, Kunshan, PR China
| | - Qihong Qin
- Department of Emergency, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, PR China
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Kirsztajn GM, Silva Junior GBD, Silva AQBD, Abensur H, Romão Junior JE, Bastos MG, Calice-Silva V, Carmo LPDFD, Sandes-Freitas TVD, Abreu PF, Andreguetto BD, Cortes LGF, Oliveira MGDL, Vieira LMF, Moura-Neto JA, Andriolo A. Estimated glomerular filtration rate in clinical practice: Consensus positioning of the Brazilian Society of Nephrology (SBN) and Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML). J Bras Nefrol 2024; 46:e20230193. [PMID: 38591823 DOI: 10.1590/2175-8239-jbn-2023-0193en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 02/07/2024] [Indexed: 04/10/2024] Open
Abstract
Chronic kidney disease (CKD) represents one of today's main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease - Epidemiology) is the most recommended one. There are still some controversies regarding serum creatinine measurement and GFR estimation, since several factors can interfere in this process. An important recent change was the removal of the correction for race from the equations for estimating GFR, which overestimated kidney function, and consequently delayed the implementation of treatments such as dialysis and kidney transplantation. In this consensus document from the Brazilian Societies of Nephrology and Clinical Pathology and Laboratory Medicine, the main concepts related to the assessment of renal function are reviewed, as well as possible existing controversies and recommendations for estimating GFR in clinical practice.
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Affiliation(s)
- Gianna Mastroianni Kirsztajn
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Geraldo Bezerra da Silva Junior
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade de Fortaleza, Centro de Ciências da Saúde, Programas de Pós-Graduação em Ciências Médicas e Saúde Coletiva, Fortaleza, CE, Brazil
| | - Artur Quintiliano Bezerra da Silva
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade Federal do Rio Grande do Norte, Departamento de Medicina Integrada, Natal, RN, Brazil
| | - Hugo Abensur
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | - João Egídio Romão Junior
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | - Marcus Gomes Bastos
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, MG, Brazil
- Faculdade Ubaense Ozanam Coelho, Ubá, MG, Brazil
| | - Viviane Calice-Silva
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade da Região de Joinville, Joinville, SC, Brazil
- Fundação Pró-Rim, Joinville, SC, Brazil
| | - Lilian Pires de Freitas do Carmo
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil
| | - Tainá Veras de Sandes-Freitas
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brazil
| | - Patrícia Ferreira Abreu
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | | | - Luiz Gustavo Ferreira Cortes
- Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial, Rio de Janeiro, RJ, Brazil
- Hospital Israelita Albert Einstein, Laboratório Clínico, São Paulo, SP, Brazil
| | | | - Luisane Maria Falci Vieira
- Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial, Rio de Janeiro, RJ, Brazil
- Dasa - Diagnósticos da América S.A., São Paulo, SP, Brazil
| | - José A Moura-Neto
- Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| | - Adagmar Andriolo
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
- Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial, Rio de Janeiro, RJ, Brazil
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