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Zaitoun T, Megahed M, Elghoneimy H, Emara DM, Elsayed I, Ahmed I. Renal arterial resistive index versus novel biomarkers for the early prediction of sepsis-associated acute kidney injury. Intern Emerg Med 2024; 19:971-981. [PMID: 38446371 PMCID: PMC11186936 DOI: 10.1007/s11739-024-03558-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/05/2024] [Indexed: 03/07/2024]
Abstract
Acute kidney injury (AKI) is a critical complication of sepsis. There is a continuous need to identify and validate biomarkers for early detection. Serum and urinary biomarkers have been investigated, such as neutrophil gelatinase associated lipocalin (NGAL) and cystatin C (Cys C), but their reliability in the intensive care unit (ICU) remains unknown. Renal hemodynamics can be investigated by measuring the renal resistive index (RRI). This study aimed to compare the performance of RRI, serum NGAL (sNGAL), urinary NGAL (uNGAL), and serum Cys C levels as early predictors of the diagnosis and persistence of sepsis-associated AKI. A total of 166 adult patients with sepsis syndrome were enrolled immediately after ICU admission. Biomarkers were measured directly (T1) and on day 3 (T3). RRI was measured directly (T1) and 24 h later (T2). Patients were categorized (according to the occurrence and persistence of AKI within the first 7 days) into three groups: no AKI, transient AKI, and persistent AKI. The incidence rate of sepsis-associated AKI was 60.2%. Sixty-six patients were categorized as in the no AKI group, while another 61 were in transient AKI and only 39 were in persistent AKI. The RRI value (T1 ≥ 0.72) was the best tool for predicting AKI diagnosis (area under the receiver operating characteristic curve, AUROC = 0.905). Cys C (T1 ≥ 15.1 mg/l) was the best tool to predict the persistence of AKI (AUROC = 0.977). RRI (T1) was the best predictive tool for sepsis-associated AKI, while Cys C was the best predictor of its persistence and 28-day mortality.
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Affiliation(s)
- Taysser Zaitoun
- Critical Care Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Mohamed Megahed
- Critical Care Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hesham Elghoneimy
- Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa M Emara
- Radiodiagnosis and Interventional Radiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ibrahim Elsayed
- Critical Care Medicine Department, Faculty of Medicine, KFS University, Kafrelsheikh, Egypt
| | - Islam Ahmed
- Public Health and Community Medicine Department, Faculty of Medicine, Suez-Canal University, Ismaili, Egypt
- Pharmacy Practice and Clinical Pharmacy Department, Faculty of Pharmacy, King Salman International University, South-Sinai, Egypt
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Wang N, Han F, Pan J, Yao G, Wang Y, Xu S, Xiao W, Ding Y, Xu C. Serum Cys C predicts acute kidney injury in patients with acute pancreatitis: A retrospective study. Arab J Gastroenterol 2023; 24:238-244. [PMID: 37989670 DOI: 10.1016/j.ajg.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/23/2023] [Accepted: 09/05/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND AND STUDY AIMS We investigated the value of the serum cystatin C level as a potential predictor of acute kidney injury (AKI) in patients with acute pancreatitis (AP). PATIENTS AND METHODS We retrospectively examined patients diagnosed with AP between January 2013 and December 2018. Patients were categorized into two groups based on their serum cystatin C levels after admission: the normal (n-Cys C group) and high serum cystatin C levels groups (h-Cys C group). Patients in the h-Cys C group demonstrated serum cystatin C levels ≥1.05 mg/L. Demographic parameters, laboratory data, and AP severity were compared between the two groups. Receiver operating curve (ROC) analysis was used to evaluate the efficacy of serum cystatin C in predicting persistent AKI. RESULTS A total of 379 patients with AP were enrolled: 319 in the n-Cys C group and 60 in the h-Cys C group. Serum cystatin C levels were significantly higher in patients with severe acute pancreatitis (SAP) compared to moderate acute pancreatitis (MAP) (P< 0.05). The h-Cys C group had a higher BISAP score (P < 0.001). Incidences of organ failure and SAP were significantly higher in the h-Cys C group (P < 0.05). ROC analysis indicated that a serum cystatin C cutoff point of 1.055 mg/L optimally predicted persistent AKI (AUC = 0.711). For internal validation, we selected 545 AP patients, treated at our center from 2019 to 2022, including 54 AKI patients. ROC analysis in this validation group yielded a sensitivity of 100% and specificity of 90.9% (AUC = 0.916, 95% CI: 0.894-0.937). CONCLUSION Elevated serum cystatin C levels are sensitive indicators of adverse AKI prognosis in AP patients. The cystatin C level at admission can reflect a patient's initial renal function status.
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Affiliation(s)
- Ningzhi Wang
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China; Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Fei Han
- Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Jiajia Pan
- Intensive Care Unit, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Guanghuai Yao
- Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Yao Wang
- Department of Nephrology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Songxin Xu
- Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Weiming Xiao
- Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Yanbing Ding
- Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
| | - Chunfang Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
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Xu Y, Qi W. Association between red cell distribution width to albumin ratio and acute kidney injury in patients with sepsis: a MIMIC population-based study. Int Urol Nephrol 2023; 55:2943-2950. [PMID: 37014490 DOI: 10.1007/s11255-023-03572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE To investigate the association between red cell distribution width (RDW) to albumin (ALB) ratio and acute kidney injury (AKI) in sepsis. METHODS This was a retrospective cohort study. Data were collected from the Medical Information Mart for Intensive Care Database IV (MIMIC-IV) from 2008 to 2019. The incidence of AKI was the primary outcome, which was defined based on the improving Global Outcomes (KDIGO). The association of RDW/ALB ratio with AKI in sepsis was assessed by multivariate logistic regression analysis using relative risk (RR) and a 95% confidence interval (CI). Subgroup group analyses were applied according to age, use of ventilation, and use of vasopressor, SAPS II, and SOFA. RESULTS Of 1810 sepsis patients involved in this study, 563 (31.10%) sepsis patients developed AKI after ICU admission. The results suggested an increase in RDW/ALB was associated with a rise in the risk of AKI in sepsis (RR 1.09, 95% CI 1.02 to 1.16, P = 0.013).Based on the subgroup analysis, RDW/ALB ratio was significantly associated with the risk of AKI in sepsis patients using the treatment of ventilation (RR: 1.07, 95% CI 1.01 to 1.14, P = 0.041)) and in patients with SAPS II < 43 (RR: 1.16, 95% CI 1.04 to 1.29, P = 0.007). CONCLUSION RDW/ALB ratio was independently associated with the risk of AKI in sepsis patients.
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Affiliation(s)
- Yang Xu
- Department of Emergency Medicine, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, No. 188, Lingshan North Road, Qixia District, Nanjing, 210046, People's Republic of China
- Department of Emergency Medicine, Taikang Xianlin Drum Tower Hospital Clinical College of Wuhan University, Nanjing, 210046, People's Republic of China
| | - Wei Qi
- Department of Emergency Medicine, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, No. 188, Lingshan North Road, Qixia District, Nanjing, 210046, People's Republic of China.
- Department of Emergency Medicine, Taikang Xianlin Drum Tower Hospital Clinical College of Wuhan University, Nanjing, 210046, People's Republic of China.
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Alnezary FS, Almutairi MS, Gonzales-Luna AJ, Thabit AK. The Significance of Bayesian Pharmacokinetics in Dosing for Critically Ill Patients: A Primer for Clinicians Using Vancomycin as an Example. Antibiotics (Basel) 2023; 12:1441. [PMID: 37760737 PMCID: PMC10525617 DOI: 10.3390/antibiotics12091441] [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: 08/14/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Antibiotic use is becoming increasingly challenging with the emergence of multidrug-resistant organisms. Pharmacokinetic (PK) alterations result from complex pathophysiologic changes in some patient populations, particularly those with critical illness. Therefore, antibiotic dose individualization in such populations is warranted. Recently, there have been advances in dose optimization strategies to improve the utilization of existing antibiotics. Bayesian-based dosing is one of the novel approaches that could help clinicians achieve target concentrations in a greater percentage of their patients earlier during therapy. This review summarizes the advantages and disadvantages of current approaches to antibiotic dosing, with a focus on critically ill patients, and discusses the use of Bayesian methods to optimize vancomycin dosing. The Bayesian method of antibiotic dosing was developed to provide more precise predictions of drug concentrations and target achievement early in therapy. It has benefits such as the incorporation of personalized PK/PD parameters, improved predictive abilities, and improved patient outcomes. Recent vancomycin dosing guidelines emphasize the importance of using the Bayesian method. The Bayesian method is able to achieve appropriate antibiotic dosing prior to the patient reaching the steady state, allowing the patient to receive the right drug at the right dose earlier in therapy.
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Affiliation(s)
- Faris S. Alnezary
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Madinah 41477, Saudi Arabia;
| | - Masaad Saeed Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Anne J. Gonzales-Luna
- Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Houston, TX 77204, USA;
| | - Abrar K. Thabit
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, 7027 Abdullah Al-Sulaiman Rd, Jeddah 21589, Saudi Arabia;
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Luo P, Ao W, Xiang D, Wang J, Liu J. Values of serum neutrophil gelatinase-associated lipocalin and cystatin C after percutaneous coronary intervention for early diagnosis of contrast-induced nephropathy. Afr Health Sci 2023; 23:593-598. [PMID: 38357177 PMCID: PMC10862628 DOI: 10.4314/ahs.v23i3.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Objective Serum creatinine (SCr) is not a sensitive and reliable index for the early diagnosis of acute kidney injury caused by contrast-induced nephropathy (CIN). The aim of this study was to explore the values of serum neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (Cys-C) after percutaneous coronary intervention (PCI) for the early diagnosis of CIN. Methods Three hundred patients receiving PCI from January 2018 to December 2020 were assigned to a CIN group (n=25) and a non-CIN group (n=275), respectively. SCr, Cys-C and NGAL levels were measured, and their sensitivities for early CIN diagnosis were evaluated by the area under the receiver operating characteristic curve (AUC) values. Results The NGAL and Cys-C levels of the CIN group began to rise 6 and 12 h after operation, respectively (P<0.05). The CIN group had higher NGAL and Cys-C levels than those of the non-CIN group 12, 24 and 48 h after operation (P<0.05). The AUC values of NGAL, Cys-C and SCr 24 h after operation were 0.885, 0.874 and 0.856, respectively. Conclusion The serum NGAL and Cys-C levels of patients after PCI reflect the early changes of renal function, which are valuable for early CIN diagnosis.
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Affiliation(s)
- Ping Luo
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Wei Ao
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Dikai Xiang
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Jian Wang
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Jia Liu
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
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Patel ML, Mishra H, Sachan R, Singh VK, Gangwar R, Ali W. Diagnostic Accuracy of Plasma Cystatin C and Renal Resistive Index for Acute Kidney Injury in Critically Ill Patients: A Prospective Observational Study. Niger Med J 2023; 64:692-703. [PMID: 38962107 PMCID: PMC11218858 DOI: 10.60787/nmj-64-5-292] [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: 07/05/2024] Open
Abstract
Background Acute kidney injury (AKI) is a quite common problem in critically ill patients. Serum cystatin C has emerged as a marker of AKI. This study was aimed to evaluate the diagnostic ability of serum Cystatin-C and Renal Resistive Index in prediction of AKI among critically ill patients. Methodology This prospective observational study was carried out in the department of Medicine, over a period of one year. After informed consent and ethical clearance total 120 critically ill patients suffering from sepsis were enrolled, out of which 70 patients developed AKI while 50 did not develop AKI during treatment in Intensive care unit (ICU). Serum cystatin C was measured on day 1 by particle-enhanced immune nephelometric assay, Renal resistive index (RRI) calculated by ratio of the velocities of arterial perfusion throughout the cardiac phase and glomerular filtration rate was measured on days 1, 3, and 7 respectively. Results S. cystatin C value was significantly higher(>3times) in AKI patients (14.07±4.8 mcg/ml) as compared to those who did not develop AKI (4.28±3.27 mcg/ml) (p<0.001). After ROC analysis it was found that day1, S. cystatin C, at cut off value of ≥9.29 mcg/ml had diagnostic accuracy 90% with sensitivity 91%, specificity89% and PPV 95.5%. While RRI value on day 7, at cut-off value of ≥0.72, had diagnostic accuracy 98%, sensitivity (98.6%) and specificity (96.7%) for AKI with 98.6% PPV, 96.7% NPV. Conclusion Serum cystatin C appears to be a promising bio- markers for early diagnosis of AKI in critically ill patients. Whereas, RRI although non-invasive had good diagnostic accuracy but it diagnosed AKI after few days thus diagnosis of kidney injury delayed.
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Affiliation(s)
- Munna Lal Patel
- Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Himanshu Mishra
- Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rekha Sachan
- Department of Obstetrics & Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Vipin Kumar Singh
- Department of Anaesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Radheyshyam Gangwar
- Department of Geriatric Mental Health, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Wahid Ali
- Department of Pathology, King George Medical University, Lucknow, Uttar Pradesh, India
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Roy R, MacDonald J, Dark P, Kalra PA, Green D. The estimation of glomerular filtration in acute and critical illness: Challenges and opportunities. Clin Biochem 2023; 118:110608. [PMID: 37479107 DOI: 10.1016/j.clinbiochem.2023.110608] [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: 02/20/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/23/2023]
Abstract
Recent events have made it apparent that the creatinine based estimating equations for glomerular filtration have their flaws. Some flaws have been known for some time; others have prompted radical modification of the equations themselves. These issues persist in part owing to the behaviour of the creatinine molecule itself, particularly in acute and critical illness. There are significant implications for patient treatment decisions, including drug and fluid therapies and choice of imaging modality (contrast vs. non-contrast CT scan for example). An alternative biomarker, Cystatin C, has been used with some success both alone and in combination with creatinine to help improve the accuracy of particular estimating equations. Problems remain in certain circumstances and costs may limit the more widespread use of the alternative assay. This review will explore both the historical and more recent evidence for glomerular filtration estimation, including options to directly measure glomerular filtration (rather than estimate), perhaps the holy grail for both Biochemistry and Nephrology.
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Affiliation(s)
- Reuben Roy
- The University of Manchester, Manchester, Greater Manchester, United Kingdom.
| | - John MacDonald
- Northern Care Alliance NHS Foundation Trust Salford Care Organisation, Salford, Greater Manchester M6 8HD, United Kingdom
| | - Paul Dark
- The University of Manchester, Manchester, Greater Manchester, United Kingdom
| | - Philip A Kalra
- Northern Care Alliance NHS Foundation Trust Salford Care Organisation, Salford, Greater Manchester M6 8HD, United Kingdom
| | - Darren Green
- Northern Care Alliance NHS Foundation Trust Salford Care Organisation, Salford, Greater Manchester M6 8HD, United Kingdom
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Jefferies JL, Kovesdy CP, Ronco C. Contemporary laboratory assessment of acute cardiorenal syndrome for early diagnosis: A call for action. Am Heart J 2023; 261:75-84. [PMID: 36948370 DOI: 10.1016/j.ahj.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 05/26/2023]
Abstract
Acute cardiorenal syndrome (CRS), categorized as CRS type 1 and 3, is defined by the interplay of acute kidney injury or dysfunction and acute cardiac disease. For optimized diagnosis and management of CRS, strategies targeting multi-organ dysfunction must be adopted. Early diagnosis of acute CRS is important to enable timely initiation of appropriate treatment to prevent serious morbidity and mortality; however, traditional biomarkers are suboptimal. Over the past 2 decades, numerous biomarkers have been investigated for a better and more rapid diagnosis of CRS. Yet, the uptake of these contemporary biomarkers has been slow, possibly owing to the use of imperfect gold-standard reference tests. We believe that there is now scope for use of contemporary laboratory test panels to improve the diagnosis of acute CRS. In this review, we briefly discuss a proposed set of biomarkers for the diagnosis of type 1 and type 3 CRS.
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Affiliation(s)
- John L Jefferies
- Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Csaba P Kovesdy
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Claudio Ronco
- Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
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Taha MM, Mahdy-Abdallah H, Shahy EM, Helmy MA, ElLaithy LS. Diagnostic efficacy of cystatin-c in association with different ACE genes predicting renal insufficiency in T2DM. Sci Rep 2023; 13:5288. [PMID: 37002266 PMCID: PMC10066320 DOI: 10.1038/s41598-023-32012-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/21/2023] [Indexed: 04/04/2023] Open
Abstract
Diabetic nephropathy (DN) seems to be the major cause of chronic kidney disease that may finally lead to End Stage Renal Disease. So, renal function assessment in type 2 diabetes mellitus (T2DM) individuals is very important. Clearly, DN pathogenesis is multifactorial and different proteins, genes and environmental factors can contribute to the onset of the disease. We assessed sensitive and specific biomarkers (in blood and urine) which can predict kidney disease susceptibility among T2DM patients. Serum cystatin-c (cyst-c) in blood and urinary hemeoxygenase (HO-1) in addition to ACE I/D polymorphism and ACE G2350A genotypes. Hundred and eight T2DM patients and 85 controls were enrolled. Serum cystatin-c and urinary (HO-1) were tested by ELISA. Genetic determination of both ACE I/D polymorphism and ACE G2350A genotypes was performed by PCR for all participants. Significant rise in serum cystatin-c and urinary HO-1 levels were shown in diabetic groups compared with control group. Moreover, GG genotype of ACE G2350A gene in diabetic group was associated with rise in serum cystatin-c and urinary HO-1 compared with control group. Mutant AA genotype demonstrated increase in urinary HO-1. DD polymorphism was associated with rise in serum creatinine and cyst-c in diabetic group. Positive correlation was seen between duration of diabetes and serum cyst-c and between serum glucose and urinary (HO-1) in diabetic group. The results from this study indicated an association of serum cystatin-c with GG genotype of ACE G2350A in conjugation with DD polymorphism of ACE I/D which could be an early predictor of tubular injury in T2DM diabetic patients.
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Affiliation(s)
- Mona Mohamed Taha
- Department of Environmental and Occupational Medicine, National Research Centre, Dokki, Cairo, Egypt.
| | - Heba Mahdy-Abdallah
- Department of Environmental and Occupational Medicine, National Research Centre, Dokki, Cairo, Egypt
| | - Eman Mohamed Shahy
- Department of Environmental and Occupational Medicine, National Research Centre, Dokki, Cairo, Egypt
| | - Mona Adel Helmy
- Department of Environmental and Occupational Medicine, National Research Centre, Dokki, Cairo, Egypt
| | - Lamia Samir ElLaithy
- Department of Environmental and Occupational Medicine, National Research Centre, Dokki, Cairo, Egypt
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Serum Cystatin C Level Monitoring for Intervention Opportunity of CBP in Children with Severe Sepsis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8571203. [PMID: 35815274 PMCID: PMC9259228 DOI: 10.1155/2022/8571203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022]
Abstract
Objective The aim of this study is to investigate the instruction value of the serum cystatin C (Cys C) level monitoring for intervention opportunity of continuous blood purification technology (CBP) in children with severe sepsis. Methods 67 children with severe sepsis in the pediatric intensive care unit (PICU) with CBP treatment were retrospectively selected from May 2016 to April 2020. According to the time intervals between the time point of serum Cys C level began to increase (>15 mg/L) and the time point of CBP began, all children were divided into group A (<24 h, 29 cases), group B (24–48 h, 22 cases), and group C (>48 h, 16 cases). The children's general characteristics, vital signs, biochemical parameters, acute physiology and chronic health evaluation (APACHE II), and sequential organ failure assessment (SOFA) scores were evaluated. The influence factors of prognosis of children with severe sepsis were analyzed by multivariate regression analysis. Results The intervals between the time point of PICU hospitalization and the time point of CBP began and the times of CBP in group A were significantly more than those in group B and C (P < 0.05). There was no statistically significant duration of CBP among three groups (P > 0.05). After follow-up of 28 d, there was no significant difference on the occurrence of coagulation disorders and hypovolemic shock induced by CBP among three groups (P > 0.05). However, the mortality of children in group A was lower than that in group C (P < 0.05). Children in group A had lower APACHE II scores, SOFA scores, serum K+, blood urea nitrogen (BUN), serum creatine (SCr), partial pressure of carbon dioxide (PCO2), and higher partial pressure of oxygen (PO2) than those of children in group C after CBP. (P < 0.05). SOFA scores ≥5 after CBP treatment and the time intervals between the time point of serum Cys C level began to increase (>15 mg/L) and the time point of CBP began ≥24 h were the independent influence factors on the prognosis by multivariate regression analysis. Conclusion There are significant evidences that continuous blood purification technology within 24 h of serum Cys C level may better control the condition of children with severe sepsis.
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Senousy SR, El-Daly M, Ibrahim ARN, Khalifa MMA, Ahmed ASF. Effect of Celecoxib and Infliximab against Multiple Organ Damage Induced by Sepsis in Rats: A Comparative Study. Biomedicines 2022; 10:biomedicines10071613. [PMID: 35884918 PMCID: PMC9312943 DOI: 10.3390/biomedicines10071613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 12/30/2022] Open
Abstract
In cases of sepsis, the immune system responds with an uncontrolled release of proinflammatory cytokines and reactive oxygen species. The lungs, kidneys, and liver are among the early impacted organs during sepsis and are a direct cause of mortality. The aim of this study was to compare the effects of infliximab (IFX) and celecoxib (CLX) on septic rats that went through a cecal ligation and puncture (CLP) surgery to induce sepsis. This study included four groups: sham, CLP (untreated), and CLP-treated with CLX or IFX. The administration of “low dose” CLX or IFX was performed after 2 h following the induction of sepsis. Twenty-four hours following the induction of sepsis, the rats were sacrificed and blood samples were collected to evaluate kidney, liver, and lung injuries. MDA and NOx content, in addition to SOD activity and GSH levels, were evaluated in the tissue homogenates of each group. Tissue samples were also investigated histopathologically. In a separate experiment, the same groups were employed to evaluate the survival of septic rats in a 7-day observation period. The results of this study showed that treatment with either CLX or IFX ameliorated the three organs’ damage compared to septic-untreated rats, decreased oxidative stress, enhanced the antioxidant defense, and reduced serum cytokines. As a result, a higher survival rate resulted: 62.5% and 37.5% after the administration of CLX and IFX, respectively, compared to 0% in the CLP group after 7 days. No significant differences were observed between the two agents in all measured parameters. Histopathological examination confirmed the observed results. In conclusion, CLX and IFX ameliorated lung, kidney, and liver injuries associated with sepsis through anti-inflammatory and antioxidant actions, which correlated to the increase in survival observed with both of them.
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Affiliation(s)
- Shaymaa Ramzy Senousy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, Minia 61511, Egypt; (S.R.S.); (M.E.-D.); (M.M.A.K.); (A.-S.F.A.)
| | - Mahmoud El-Daly
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, Minia 61511, Egypt; (S.R.S.); (M.E.-D.); (M.M.A.K.); (A.-S.F.A.)
| | - Ahmed R. N. Ibrahim
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
- Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia 61511, Egypt
- Correspondence: ; Tel.: +96-65-5408-8979
| | - Mohamed Montaser A. Khalifa
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, Minia 61511, Egypt; (S.R.S.); (M.E.-D.); (M.M.A.K.); (A.-S.F.A.)
| | - Al-Shaimaa F. Ahmed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Minia University, Minia 61511, Egypt; (S.R.S.); (M.E.-D.); (M.M.A.K.); (A.-S.F.A.)
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Pei Y, Zhou G, Wang P, Shi F, Ma X, Zhu J. Serum cystatin C, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, klotho and fibroblast growth factor-23 in the early prediction of acute kidney injury associated with sepsis in a Chinese emergency cohort study. Eur J Med Res 2022; 27:39. [PMID: 35272698 PMCID: PMC8915476 DOI: 10.1186/s40001-022-00654-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Acute kidney injury (AKI) is a common and critical complication of sepsis, and is associated with unacceptable morbidity and mortality. Current diagnostic criteria for AKI was insensitive for early detection. Novel biomarkers including cystatin C, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), klotho and fibroblast growth factor-23 (FGF-23) can predict AKI earlier and allow immediate interventions. We aimed to determine the diagnostic performance of these biomarkers for detecting AKI in sepsis patients. Methods This prospective observational study was conducted between May 2018 and November 2020, enrolling 162 sepsis patients eventually. The AKI was defined in accordance with 2012 KDIGO criteria and we divided patients into non-AKI (n = 102) and AKI (n = 60) groups. Serum levels of several AKI biomarkers were detected by ELISA. The relationship between biomarker levels on admission of AKI was analyzed and discrimination performances comparison were performed. Results AKI incidence was up to 37.0% (60/162) during hospitalization. Compared with non-AKI group, both serum cystatin C, KIM-1, NGAL and FGF-23 were significantly elevated at admission in septic AKI patients. The areas under the receiver operating curves demonstrated that serum cystatin C had modest discriminative powers for predicting AKI after sepsis, and cystatin C combined with serum creatinine in the prediction of septic AKI increased the diagnostic sensitivity prominently. Conclusion Serum cystatin C, KIM-1, NGAL and FGF-23 levels were both increased in septic AKI patients. Our study provided reliable evidence that cystatin C solely and combined with serum creatinine may accurately and sensitively predict septic AKI of patients on admission.
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Affiliation(s)
- Yuanyuan Pei
- Emergency Department, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Guangping Zhou
- Emergency Department, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Pengfei Wang
- Emergency Department, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Fang'e Shi
- Emergency Department, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Xiaolu Ma
- Emergency Department, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Jihong Zhu
- Emergency Department, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, China.
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Lee KH, Chu YC, Tsai MT, Tseng WC, Lin YP, Ou SM, Tarng DC. Artificial Intelligence for Risk Prediction of End-Stage Renal Disease in Sepsis Survivors with Chronic Kidney Disease. Biomedicines 2022; 10:biomedicines10030546. [PMID: 35327348 PMCID: PMC8945427 DOI: 10.3390/biomedicines10030546] [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: 01/23/2022] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023] Open
Abstract
Sepsis may lead to kidney function decline in patients with chronic kidney disease (CKD), and the deleterious effect may persist in patients who survive sepsis. We used a machine learning approach to predict the risk of end-stage renal disease (ESRD) in sepsis survivors. A total of 11,661 sepsis survivors were identified from a single-center database of 112,628 CKD patients between 2010 and 2018. During a median follow-up of 3.5 years, a total of 1366 (11.7%) sepsis survivors developed ESRD after hospital discharge. We adopted the random forest, extra trees, extreme gradient boosting, light gradient boosting machine (LGBM), and gradient boosting decision tree (GBDT) algorithms to predict the risk of ESRD development among these patients. GBDT yielded the highest area under the receiver operating characteristic curve of 0.879, followed by LGBM (0.868), and extra trees (0.865). The GBDT model revealed the strong effect of estimated glomerular filtration rates <25 mL/min/1.73 m2 at discharge in predicting ESRD development. In addition, hemoglobin and proteinuria were also essential predictors. Based on a large-scale dataset, we established a machine learning model computing the risk for ESRD occurrence among sepsis survivors with CKD. External validation is required to evaluate the generalizability of this model.
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Affiliation(s)
- Kuo-Hua Lee
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (M.-T.T.); (W.-C.T.); (Y.-P.L.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Hsinchu 30010, Taiwan
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Big Data Center, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Ming-Tsun Tsai
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (M.-T.T.); (W.-C.T.); (Y.-P.L.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Hsinchu 30010, Taiwan
| | - Wei-Cheng Tseng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (M.-T.T.); (W.-C.T.); (Y.-P.L.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Hsinchu 30010, Taiwan
| | - Yao-Ping Lin
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (M.-T.T.); (W.-C.T.); (Y.-P.L.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Hsinchu 30010, Taiwan
| | - Shuo-Ming Ou
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (M.-T.T.); (W.-C.T.); (Y.-P.L.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Hsinchu 30010, Taiwan
- Correspondence: (S.-M.O.); (D.-C.T.); Tel.: +886-2-2875-7517 (D.-C.T.); Fax: +886-2-2875-7841 (D.-C.T.)
| | - Der-Cherng Tarng
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (K.-H.L.); (M.-T.T.); (W.-C.T.); (Y.-P.L.)
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), Hsinchu 30010, Taiwan
- Big Data Center, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Department and Institute of Physiology, National Yang-Ming University, Taipei 11217, Taiwan
- Correspondence: (S.-M.O.); (D.-C.T.); Tel.: +886-2-2875-7517 (D.-C.T.); Fax: +886-2-2875-7841 (D.-C.T.)
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Stankute I, Radzeviciene L, Monstaviciene A, Dobrovolskiene R, Danyte E, Verkauskiene R. Serum Cystatin C as a Biomarker for Early Diabetic Kidney Disease and Dyslipidemia in Young Type 1 Diabetes Patients. Medicina (B Aires) 2022; 58:medicina58020218. [PMID: 35208542 PMCID: PMC8878987 DOI: 10.3390/medicina58020218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives: This study aimed to assess the clinical significance of serum cystatin C in the early diagnosis of renal injury and its association with dyslipidemia in young T1D patients. Materials and Methods: A total of 779 subjects were evaluated for kidney function by estimating glomerular filtration rate (eGFR) based on serum creatinine (eGFRcreat) and cystatin C (eGFRcys). Results: The median age of study subjects was 16.2 years (2.1;26.4), diabetes duration—5.3 years (0.51;24.0). The median of HbA1c was 8% (5.2;19.9) (64 mmol/mol (33.3;194)); 24.2% of participants had HbA1c < 7% (53 mmol/mol). Elevated albumin excretion rate was found in 13.5% of subjects. The median of cystatin C was 0.8 mg/L (0.33;1.71), the median of creatinine—63 µmol/L (6;126). The median of eGFRcys was lower than eGFRcreat (92 mL/min/1.73 m2 vs. 101 mL/min/1.73 m2, p < 0.001). A total of 30.2% of all patients were classified as having worse kidney function when using cystatin C vs. creatinine for eGFR calculation. Linear correlations were found between cystatin C and HbA1c, r = −0.088, p < 0.05, as well as cystatin C and HDL, r = −0.097, p < 0.01. Conclusions: This study showed that cystatin C might be used as an additional biomarker of early kidney injury in young patients with T1D.
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Affiliation(s)
- Ingrida Stankute
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50009 Kaunas, Lithuania; (L.R.); (E.D.); (R.V.)
- Correspondence: or
| | - Lina Radzeviciene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50009 Kaunas, Lithuania; (L.R.); (E.D.); (R.V.)
| | - Ausra Monstaviciene
- Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania; (A.M.); (R.D.)
| | - Rimante Dobrovolskiene
- Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania; (A.M.); (R.D.)
| | - Evalda Danyte
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50009 Kaunas, Lithuania; (L.R.); (E.D.); (R.V.)
| | - Rasa Verkauskiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50009 Kaunas, Lithuania; (L.R.); (E.D.); (R.V.)
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Serum Cystatin, Chemokine, and Gastrin-Releasing Peptide Precursors and Their Clinical Value in Patients with Chronic Renal Failure. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1775190. [PMID: 35097109 PMCID: PMC8799334 DOI: 10.1155/2022/1775190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022]
Abstract
Objective. To investigate the serum cystatin (CysC), Chemerin, and gastrin-releasing peptide precursor (ProGRP) levels in patients with chronic renal failure (CRF). Methods. CRF patients admitted to our hospital from February 2019 to July 2019 were selected as the observation group, and 50 healthy patients were selected as the control group. The serum levels of CysC, Chemerin, ProGRP, and Scr of all subjects were detected. Patients with CRF were admitted for peritoneal dialysis (PD) treatment for 1 week, and continued treatment was performed. The survival rate of patients with CRF in nearly 1 year after continuous treatment was observed. Multivariate analysis of factors affecting survival time of CRF patients undergoing peritoneal dialysis was performed. The results were compared with those in the health group. The expression levels of CysC, Chemerin, ProGRP, and Scr in the observation group were all decreased, and the differences were statistically significant (
). Pearson correlation analysis showed that Scr expression in CRF patients is positively correlated with CysC, Chemerin, and ProGRP (
). The survival rate of 98 patients with CRF was 80.61% (79/98), and the mortality rate was 19.39% (19/98). Serum levels of CysC, Chemerin, ProGRP, and Scr in the death group are all higher than those in the survival group, and the differences are statistically significant (
). CysC, Chemerin, ProGRP, and Scr are independent risk factors affecting survival time (
). The AUC aspects of serum CysC, Chemerin, ProGRP, and Scr in predicting the survival rate of CRF patients in the treatment phase are 0.840, 0.775, 0.782, and 0.725, respectively. Conclusion. The serum levels of CysC, Chemerin, and ProGRP of CRF patients are abnormally elevated and are positively correlated with serum Scr of patients, which can be used as a reliable indicator of pathogenesis and prognosis assessment of CRF patients.
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Xin Q, Xie T, Chen R, Wang H, Zhang X, Wang S, Liu C, Zhang J. Predictive nomogram model for major adverse kidney events within 30 days in sepsis patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:1024500. [PMID: 36589822 PMCID: PMC9800518 DOI: 10.3389/fendo.2022.1024500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In sepsis patients, Type 2 Diabetes Mellitus (T2DM) was associated with an increased risk of kidney injury. Furthermore, kidney damage is among the dangerous complications, with a high mortality rate in sepsis patients. However, the underlying predictive model on the prediction of major adverse kidney events within 30 days (MAKE30) in sepsis patients with T2DM has not been reported by any study. METHODS A total of 406 sepsis patients with T2DM were retrospectively enrolled and divided into a non-MAKE30 group (261 cases) and a MAKE30 group (145 cases). In sepsis patients with T2DM, univariate and multivariate logistic regression analyses were conducted to identify independent predictors of MAKE30. Based on the findings of multivariate logistic regression analysis, the corresponding nomogram was constructed. The nomogram was evaluated using the calibration curve, Receiver Operating Characteristic (ROC) curve, and decision curve analysis. A composite of death, new Renal Replacement Therapy (RRT), or Persistent Renal Dysfunction (PRD) comprised MAKE30. Finally, subgroup analyses of the nomogram for 30-day mortality, new RRT, and PRD were performed. RESULTS In sepsis patients with T2DM, Mean Arterial Pressure (MAP), Platelet (PLT), cystatin C, High-Density Lipoprotein (HDL), and apolipoprotein E (apoE) were independent predictors for MAKE30. According to the ROC curve, calibration curve, and decision curve analysis, the nomogram model based on those predictors had satisfactory discrimination (AUC = 0.916), good calibration, and clinical application. Additionally, in sepsis patients with T2DM, the nomogram model exhibited a high ability to predict the occurrence of 30-day mortality (AUC = 0.822), new RRT (AUC = 0.874), and PRD (AUC = 0.801). CONCLUSION The nomogram model, which is available within 24 hours after admission, had a robust and accurate assessment for the MAKE30 occurrence, and it provided information to better manage sepsis patients with T2DM.
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Affiliation(s)
- Qi Xin
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Tonghui Xie
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Rui Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Hai Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xing Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Shufeng Wang
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
- *Correspondence: Shufeng Wang, ; Chang Liu, ; Jingyao Zhang,
| | - Chang Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
- *Correspondence: Shufeng Wang, ; Chang Liu, ; Jingyao Zhang,
| | - Jingyao Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
- *Correspondence: Shufeng Wang, ; Chang Liu, ; Jingyao Zhang,
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Al-Amodi HS, Abdelsattar S, Kasemy ZA, Bedair HM, Elbarbary HS, Kamel HFM. Potential Value of TNF-α (-376 G/A) Polymorphism and Cystatin C (CysC) in the Diagnosis of Sepsis Associated Acute Kidney Injury (S-AK I) and Prediction of Mortality in Critically Ill patients. Front Mol Biosci 2021; 8:751299. [PMID: 34692772 PMCID: PMC8526786 DOI: 10.3389/fmolb.2021.751299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022] Open
Abstract
Sepsis Associated Kidney Injury represents a major health concern as it is frequently associated with increased risk of mortality and morbidity. We aimed to evaluate the potential value of TNF-α (-376 G/A) and cystatin C in the diagnosis of S-AKI and prediction of mortality in critically ill patients. This study included 200 critically ill patients and 200 healthy controls. Patients were categorized into 116 with acute septic shock and 84 with sepsis, from which 142 (71%) developed S-AKI. Genotyping of TNF-α (-376 G/A) was performed by RT-PCR and serum CysC was assessed by Enzyme Linked Immunosorbent Assay. Our results showed a highly significant difference in the genotype frequencies of TNF-α (-376 G/A) SNP between S-AKI and non-AKI patients (p < 0.001). Additionally, sCysC levels were significantly higher in the S-AKI group (p = 0.011). The combination of both sCysC and TNF-α (-376 G/A) together had a better diagnostic ability for S-AKI than sCysC alone (AUC = 0.610, 0.838, respectively). Both GA and AA genotypes were independent predictors of S-AKI (p= < 0.001, p = 0.002 respectively). Additionally, sCysC was significantly associated with the risk of S-AKI development (Odds Ratio = 1.111). Both genotypes and sCysC were significant predictors of non-survival (p < 0.001), suggesting their potential role in the diagnosis of S-AKI and prediction of mortality.
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Affiliation(s)
- Hiba S Al-Amodi
- Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Shimaa Abdelsattar
- Clinical Biochemistry and Molecular Diagnostics Department, National Liver Institute, Menoufia University, Shebine Elkoum, Egypt
| | - Zeinab A. Kasemy
- Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Shebine Elkoum, Egypt
| | - Hanan M. Bedair
- Clinical Pathology Department, National Liver Institute, Menoufia University, Shebine Elkoum, Egypt
| | - Hany S. Elbarbary
- Department of Internal Medicine, Renal Unit, Faculty of Medicine, Menoufia University, Shebine Elkoum, Egypt
- Department of Internal Medicine, Renal Unit, Faculty of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Hala F. M. Kamel
- Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Jyoti A, Kumar S, Kumar Srivastava V, Kaushik S, Govind Singh S. Neonatal sepsis at point of care. Clin Chim Acta 2021; 521:45-58. [PMID: 34153274 DOI: 10.1016/j.cca.2021.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 01/03/2023]
Abstract
Sepsis, which includes infection followed by inflammation, is one of the leading causes of death among neonates worldwide. The major attribute of this disease process is dysregulated host response to infection leading to organ dysfunction and potentially death. A comprehensive understanding of the host response as well as the pathogen itself are important factors contributing to outcome. Early diagnosis is paramount, as it leads to accurate assessment and improved clinical management. Accordingly, a number of diagnostic platforms have been introduced to assess the presence of blood stream pathogens in septic neonates. Unfortunately, current point-of-care (POC) methods rely on a single parameter/biomarker and thus lack a comprehensive evaluation. The emerging field of biosensing has, however, resulted in the development of a wide range of analytical devices that may be useful at POC. This review discusses currently available methods to screen the inflammatory process in neonatal sepsis. We describe POC sensor-based methods for single platform multi-analyte detection and highlight the latest advances in this evolving technology. Finally, we critically evaluate the applicability of these POC devices clinically for early diagnosis of sepsis in neonates.
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Affiliation(s)
- Anupam Jyoti
- Amity Institute of Biotechnology, Amity University, Jaipur, Rajasthan 303002, India; Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, 173229, India.
| | - Sanni Kumar
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, Telangana 502285, India.
| | | | - Sanket Kaushik
- Amity Institute of Biotechnology, Amity University, Jaipur, Rajasthan 303002, India.
| | - Shiv Govind Singh
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, Telangana 502285, India.
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Yao YL, Gao Y. Present Situation and Research Progress of Kidney Function Recoverability Evaluation of Acute Kidney Injury Patient. Int J Gen Med 2021; 14:1919-1925. [PMID: 34040424 PMCID: PMC8140891 DOI: 10.2147/ijgm.s303348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 12/23/2022] Open
Abstract
Acute kidney injury (AKI) is a critical illness in clinic. The guideline recommendation of kidney disease for improving global outcomes regards urine volume and creatinine as standards to evaluate kidney functions. However, urine volume and creatinine have a certain delay for kidney function evaluation, and these would be interfered by many factors. Whether the renal function of AKI patients can recover is very important, which affects the quality of life of patients. Therefore, the present study reviews the application situation and research progress of the recoverability evaluation of AKI patient kidney function from three aspects: conventional indexes, biomarkers, and imaging methods of kidney function.
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Affiliation(s)
- Yu-Long Yao
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Yuan Gao
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
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20
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Ma J, Deng Y, Lao H, Ouyang X, Liang S, Wang Y, Yao F, Deng Y, Chen C. A nomogram incorporating functional and tubular damage biomarkers to predict the risk of acute kidney injury for septic patients. BMC Nephrol 2021; 22:176. [PMID: 33985459 PMCID: PMC8120900 DOI: 10.1186/s12882-021-02388-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/26/2021] [Indexed: 12/11/2022] Open
Abstract
Background Combining tubular damage and functional biomarkers may improve prediction precision of acute kidney injury (AKI). Serum cystatin C (sCysC) represents functional damage of kidney, while urinary N-acetyl-β-D-glucosaminidase (uNAG) is considered as a tubular damage biomarker. So far, there is no nomogram containing this combination to predict AKI in septic cohort. We aimed to compare the performance of AKI prediction models with or without incorporating these two biomarkers and develop an effective nomogram for septic patients in intensive care unit (ICU). Methods This was a prospective study conducted in the mixed medical-surgical ICU of a tertiary care hospital. Adults with sepsis were enrolled. The patients were divided into development and validation cohorts in chronological order of ICU admission. A logistic regression model for AKI prediction was first constructed in the development cohort. The contribution of the biomarkers (sCysC, uNAG) to this model for AKI prediction was assessed with the area under the receiver operator characteristic curve (AUC), continuous net reclassification index (cNRI), and incremental discrimination improvement (IDI). Then nomogram was established based on the model with the best performance. This nomogram was validated in the validation cohort in terms of discrimination and calibration. The decision curve analysis (DCA) was performed to evaluate the nomogram’s clinical utility. Results Of 358 enrolled patients, 232 were in the development cohort (69 AKI), while 126 in the validation cohort (52 AKI). The first clinical model included the APACHE II score, serum creatinine, and vasopressor used at ICU admission. Adding sCysC and uNAG to this model improved the AUC to 0.831. Furthermore, incorporating them significantly improved risk reclassification over the predictive model alone, with cNRI (0.575) and IDI (0.085). A nomogram was then established based on the new model including sCysC and uNAG. Application of this nomogram in the validation cohort yielded fair discrimination with an AUC of 0.784 and good calibration. The DCA revealed good clinical utility of this nomogram. Conclusions A nomogram that incorporates functional marker (sCysC) and tubular damage marker (uNAG), together with routine clinical factors may be a useful prognostic tool for individualized prediction of AKI in septic patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02388-w.
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Affiliation(s)
- Jianchao Ma
- Department of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, PR China
| | - Yujun Deng
- Department of Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong Province, PR China
| | - Haiyan Lao
- Department of Pharmacy, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, Guangdong, PR China
| | - Xin Ouyang
- Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, PR China
| | - Silin Liang
- Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, PR China
| | - Yifan Wang
- Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, PR China
| | - Fen Yao
- Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, PR China
| | - Yiyu Deng
- Department of Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong Province, PR China.
| | - Chunbo Chen
- Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, PR China. .,The Second School of Clinical Medicine, Southern Medical University, 510280, Guangzhou, Guangdong, PR China.
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21
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Scurt FG, Bose K, Canbay A, Mertens PR, Chatzikyrkou C. [Acute kidney injury following acute pancreatitis (AP-AKI): Definition, Pathophysiology, Diagnosis and Therapy]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2020; 58:1241-1266. [PMID: 33291178 DOI: 10.1055/a-1255-3413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Acute pancreatitis (AP) is the most frequent gastrointestinal cause for hospitalization and one of the leading causes of in-hospital deaths. Severe acute pancreatitis is often associated with multiorgan failure and especially with acute kidney injury (AKI). AKI can develop early or late in the course of the disease and is a strong determinator of outcome. The mortality in the case of dialysis-dependent AKI and acute pancreatitis raises exponentially in the affected patients. AP-induced AKI (AP-AKI) shows many similarities but also distinct differences to other causes of AKI occurring in the intensive care unit setting. The knowledge of the exact pathophysiology can help to adjust, control and improve therapeutic approaches to the disease. Unfortunately, there are only a few studies dealing with AP and AKI.In this review, we discuss recent data about pathogenesis, causes and management of AP-AKI in patients with severe acute pancreatitis and exploit in this regard the diagnostic and prognostic potential of respective newer serum and urine markers.
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Affiliation(s)
- Florian Gunnar Scurt
- Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Deutschland.,Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke-University, Magdeburg, Germany
| | - Katrin Bose
- Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke-University, Magdeburg, Germany.,Universitätsklinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Otto-von-Guericke-Universität, Magdeburg, Deutschland
| | - Ali Canbay
- Ruhr-Universität Bochum, Medizinische Klinik, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland
| | - Peter R Mertens
- Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Deutschland.,Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke-University, Magdeburg, Germany
| | - Christos Chatzikyrkou
- Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Deutschland.,Health Campus Immunology, Infectiology and Inflammation, Otto-von-Guericke-University, Magdeburg, Germany
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22
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Hansson M, Gustafsson R, Jacquet C, Chebaane N, Satchell S, Thunberg T, Ahlm C, Fors Connolly AM. Cystatin C and α-1-Microglobulin Predict Severe Acute Kidney Injury in Patients with Hemorrhagic Fever with Renal Syndrome. Pathogens 2020; 9:pathogens9080666. [PMID: 32824680 PMCID: PMC7460112 DOI: 10.3390/pathogens9080666] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/29/2022] Open
Abstract
Puumala orthohantavirus causes hemorrhagic fever with renal syndrome (HFRS) characterized by acute kidney injury (AKI), an abrupt decrease in renal function. Creatinine is routinely used to detect and quantify AKI; however, early AKI may not be reflected in increased creatinine levels. Therefore, kidney injury markers that can predict AKI are needed. The potential of the kidney injury markers urea, cystatin C, α1-microglobulin (A1M) and neutrophil gelatinase-associated lipocalin (NGAL) to detect early AKI during HFRS was studied by quantifying the levels of these markers in consecutively obtained plasma (P) and urine samples (U) for 44 HFRS patients. P-cystatin C and U-A1M levels were significantly increased during early HFRS compared to follow-up. In a receiver operating characteristic (ROC) curve analysis, P-cystatin C, U-A1M and P-urea predicted severe AKI with area under the curve 0.72, 0.73 and 0.71, respectively, whereas the traditional kidney injury biomarkers creatinine and U-albumin did not predict AKI. Nearly half of the HFRS patients (41%) fulfilled the criteria for shrunken pore syndrome, which was associated with the level of inflammation as measured by P-CRP. P-cystatin C and U-A1M are more sensitive and earlier markers compared to creatinine in predicting kidney injury during HFRS.
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Affiliation(s)
- Magnus Hansson
- Clinical Chemistry, Karolinska University Hospital, 17176 Stockholm, Sweden;
- Department of Laboratory Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Rasmus Gustafsson
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Chloé Jacquet
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden; (C.J.); (N.C.); (T.T.); (C.A.)
- Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187 Umeå, Sweden
| | - Nedia Chebaane
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden; (C.J.); (N.C.); (T.T.); (C.A.)
| | - Simon Satchell
- Bristol Renal, Bristol Medical School, University of Bristol, Bristol BS1 3NY, UK;
| | - Therese Thunberg
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden; (C.J.); (N.C.); (T.T.); (C.A.)
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden; (C.J.); (N.C.); (T.T.); (C.A.)
| | - Anne-Marie Fors Connolly
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden; (C.J.); (N.C.); (T.T.); (C.A.)
- Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187 Umeå, Sweden
- Correspondence:
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23
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Xu X, Qin L, Yan L. Changes of expression levels of serum cystatin C and soluble vascular endothelial growth factor receptor 1 in the treatment of patients with glomerulus nephritis. Exp Ther Med 2020; 20:1550-1556. [PMID: 32742386 PMCID: PMC7388255 DOI: 10.3892/etm.2020.8824] [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: 06/06/2019] [Accepted: 01/20/2020] [Indexed: 12/05/2022] Open
Abstract
Expression levels and changes of serum cystatin C (C's C) and soluble vascular endothelial growth factor receptor 1 (sVEGFR1) in treatment of patients with glomerulus nephritis (GN) were investigated. The medical records of 88 patients with GN who were diagnosed in Weifang People's Hospital from March 2014 to June 2017 were collected, and their medical records were considered as a study group. The study group was divided into secondary glomerulonephritis (SGN) group (52 cases) and primary glomerulonephritis (PGN) group (36 cases). Physical examination data of 50 healthy volunteers who were examined in the same hospital during the same period were considered as a control group. The correlation between expression of serum C's C and expression of sVEGFR1 of patients with GN was compared. Expression levels of serum C's C and sVEGFR1 of patients before treatment in the study group were higher than those in the control group (P<0.05). With the extension of the treatment cycle, C's C and sVEGFR1 expression levels in PGN and SGN groups reduced gradually (P<0.05). With the extension of the treatment cycle, the renal function indexes of the study group patients showed a downward trend (P<0.05). Expression of C's C was positively correlated with urea nitrogen and creatinine (P<0.05). In conclusion, C's C and sVEGFR1 are highly expressed in the serum of patients with GN. Expression of C's C and sVEGFR1 decrease as patients are treated. C's C and sVEGFR1 can be used as indicators for monitoring the condition of patients with GN. It is worthwhile to promote C's C and sVEGFR1 in clinical practice.
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Affiliation(s)
- Xinwei Xu
- Nephrology Department, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Lili Qin
- Nephrology Department, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Liping Yan
- Human Resources Department, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
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24
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Teaford HR, Rule AD, Mara KC, Kashani KB, Lieske JC, Schreier DJ, Wieruszewski PM, Barreto EF. Patterns of Cystatin C Uptake and Use Across and Within Hospitals. Mayo Clin Proc 2020; 95:1649-1659. [PMID: 32753139 PMCID: PMC7412578 DOI: 10.1016/j.mayocp.2020.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/23/2020] [Accepted: 03/04/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To characterize the use of cystatin C (cysC) across and within hospitals. PATIENTS AND METHODS This 2-part study first evaluated access to cysC testing across 129 hospitals in the state of Minnesota, using a telephone-based survey. Second, granular data from a single center (Mayo Clinic) with on-site, rapid-turnaround testing (<1 day) and automated estimated glomerular filtration rate (eGFR) reporting was used to describe temporal patterns. The characteristics of hospitals that offered cysC testing and of patients who underwent rapid cysC testing at Mayo Clinic between January 1, 2011, and March 31, 2018, were described. Poisson regression analyzed temporal trends in cysC testing. RESULTS Of the 114 hospitals (88%) that responded to the statewide survey, cysC was available in 91 (80%), but only 3 of 91 (3%) reported a turnaround time of <1 day. At Mayo Clinic, cysC use increased from 0.74 tests per 1000 patient-days in 2011 to 14 tests per 1000 patient-days in 2018 (P=.004). Of the 3774 patients with cysC tests, the mean first available eGFR was 46 mL/min per 1.73 m2 using cysC and 59 mL/min per 1.73 m2 using serum creatinine (P<.001). CysC testing was used across all intensities of care and was ordered by a variety of specialties. Nephrology was consulted in only 42% of cases. CONCLUSION In the hospital, rapid-turnaround cysC testing is necessary for practical use but was not widely available in Minnesota. When available, a marked increase in cysC testing was observed over the study timeframe. Additional research is needed to determine optimal strategies for implementation of cysC within hospitals.
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Affiliation(s)
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Division of Epidemiology, Mayo Clinic, Rochester, MN
| | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Kianoush B Kashani
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - John C Lieske
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | | | - Erin F Barreto
- Department of Pharmacy, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
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25
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Zhao M, Che Q, Zhang Y, Qian X, Huang T. Expression and clinical significance of serum cystatin C in patients with hypertension and coronary heart disease. Medicine (Baltimore) 2020; 99:e20029. [PMID: 32481372 DOI: 10.1097/md.0000000000020029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of this study is to explore the potential association between cystatin C (Cys-c) and coronary heart disease (CHD) in hypertensive patients.In this study, circulating levels of Cys-c in 62 essential hypertension (EH) patients, 147 hypertension with coronary heart disease (EH + CHD) patients, and 60 healthy volunteers were investigated using immunoturbidimetry. Then, we analyzed the correlations between Cys-C and other clinical parameters.Serum Cys-C level was significantly higher in the EH and EH + CHD groups than in the control group, and higher in the EH + CHD group than in the EH group. Receiver operating characteristic curve (ROC) analysis showed that the diagnostic value of Cys-C for patients with hypertension combined CHD was 0.871(95% CI: 0.818-0.913). Serum Cys-C level was significantly higher in the double-vessel disease group and multi-vessel disease group than in the single-vessel disease group, and higher in the multi-vessel disease group than in the double-vessel disease group. Urinary albumin and CRP correlated positively with Cys-C, and HDL correlated negatively with Cys-C. Cys-C was an independent risk factor for CHD in hypertensive patients.Our results suggested that circulating Cys-C levels was up-regulated in patients with hypertension and CHD, and had correlation with the severity of coronary artery disease. As one of the important risk factors for CHD, Cys-C can predict the occurrence of CHD in patients with hypertension.
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Affiliation(s)
| | | | | | | | - Tong Huang
- NingBo First Hospital, Ningbo, Zhejiang, China
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26
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Wajda J, Dumnicka P, Sporek M, Maziarz B, Kolber W, Ząbek-Adamska A, Ceranowicz P, Kuźniewski M, Kuśnierz-Cabala B. Does Beta-Trace Protein (BTP) Outperform Cystatin C as a Diagnostic Marker of Acute Kidney Injury Complicating the Early Phase of Acute Pancreatitis? J Clin Med 2020; 9:jcm9010205. [PMID: 31940861 PMCID: PMC7019728 DOI: 10.3390/jcm9010205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/31/2019] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Acute pancreatitis (AP) belongs to the commonest acute gastrointestinal conditions requiring hospitalization. Acute kidney injury (AKI) often complicates moderately severe and severe AP, leading to increased mortality. Among the laboratory markers proposed for early diagnosis of AKI, few have been studied in AP, including cystatin C and neutrophil gelatinase-associated lipocalin (NGAL). Beta-trace protein (BTP), a low-molecular-weight glycoprotein proposed as an early marker of decreased glomerular filtration, has never been studied in AP. We investigated the diagnostic usefulness of serum BTP for early diagnosis of AKI complicating AP in comparison to previously studied markers. BTP was measured in serum samples collected over the first three days of hospital stay from 73 adult patients admitted within 24 h of mild to severe AP. Thirteen patients (18%) developed AKI in the early phase of AP. Serum BTP was higher in patients who developed AKI, starting from the first day of hospitalization. Strong correlations were observed between BTP and serum cystatin C but not serum or urine NGAL. On admission, BTP positively correlated with endothelial dysfunction. The diagnostic usefulness of BTP for AKI was similar to cystatin C and lower than NGAL. Increased BTP is an early predictor of AKI complicating AP. However, it does not outperform cystatin C or NGAL.
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Affiliation(s)
- Justyna Wajda
- Department of Anatomy, Jagiellonian University Medical College, 31-034 Krakow, Poland; (J.W.); (M.S.)
| | - Paulina Dumnicka
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland
- Correspondence: (P.D.); (P.C.); Tel.: +48-6205-622 (P.C.)
| | - Mateusz Sporek
- Department of Anatomy, Jagiellonian University Medical College, 31-034 Krakow, Poland; (J.W.); (M.S.)
- Surgery Department, The District Hospital, 34-200 Sucha Beskidzka, Poland
| | - Barbara Maziarz
- Department of Diagnostics, Chair of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, Poland; (B.M.); (B.K.-C.)
| | - Witold Kolber
- Department of Surgery, Complex of Health Care Centers in Wadowice, 34-100 Wadowice, Poland;
| | - Anna Ząbek-Adamska
- Diagnostics Department of University Hospital in Krakow, 31-501 Krakow, Poland;
| | - Piotr Ceranowicz
- Department of Nephrology, Jagiellonian University Medical College, 31-501 Kraków, Poland;
- Correspondence: (P.D.); (P.C.); Tel.: +48-6205-622 (P.C.)
| | - Marek Kuźniewski
- Department of Nephrology, Jagiellonian University Medical College, 31-501 Kraków, Poland;
| | - Beata Kuśnierz-Cabala
- Department of Diagnostics, Chair of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, Poland; (B.M.); (B.K.-C.)
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27
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Yu G, Sun X, Li L, Huang L, Liu H, Wang S, Ren Z, Zhang Y. Cystatin C promotes cognitive dysfunction in rats with cerebral microbleeds by inhibiting the ERK/synapsin Ia/Ib pathway. Exp Ther Med 2019; 19:2282-2290. [PMID: 32104295 DOI: 10.3892/etm.2019.8403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/10/2019] [Indexed: 12/30/2022] Open
Abstract
Although higher serum level of cystatin C (CysC) was observed in patients with cerebral microbleeds, its associated role in the disease has not been elucidated. In this work, a rat model of cerebral microbleeds was created with the aim of investigating effects of CysC on cognitive function in rats with cerebral microbleeds and the underlying mechanism. Serum samples of patients with cerebral microbleeds and healthy people of the same age were collected. Levels of cystatin C expression in these samples were measured using CysC kits. Moreover, 48 spontaneously hypertensive rats (SHRs) bred under specific pathogen-free (SPF) conditions were randomly divided into 4 groups: sham surgery control group (sham), model group (CMB), model + empty vector control group (CMB + vehicle), and model + cystatin C overexpression group (CMB + CysC). Expression levels of CysC in hippocampus of rats in each group were measured by western blot analysis. The Y-maze was used to evaluate cognitive function of rats. Hippocampal long-term potentiation (LTP) in rats was assessed by the electrophysiological assay. Alterations in levels of p-ERK1/2 and p-synapsin Ia/b proteins associated with cognitive function were identified by western blot analysis. The serum levels of CysC in patients with cerebral microbleeds were significantly upregulated (P<0.001). After injection of CysC, its expression levels in rat hippocampus were significantly increased (P<0.001), which enhanced the decline in learning and memory function, as well as the decrease of LTP in the rat model of cerebral microbleeds (P<0.001). Western blot results showed that injection of CysC further reduced the levels of p-ERK1/2 and p-synapsin Ia/b in the rat model of microbleeds (P<0.001). CysC was up regulated in serum of patients with cerebral microbleeds. It promoted cognitive dysfunction in rats with microbleeds by inhibiting ERK/synapsin Ia/Ib pathway.
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Affiliation(s)
- Guangna Yu
- Department of Physical Examination, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Xingyuan Sun
- Director's Office, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Li Li
- First Department of Neurology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Lijuan Huang
- First Department of Neurology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Hongbin Liu
- Third Department of Neurology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Shuying Wang
- Department of Imagine, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Zhanjun Ren
- Sixth Department of Neurology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
| | - Yanjiao Zhang
- First Department of Neurology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161000, P.R. China
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28
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Park HJ, Yun J, Kang DY, Park JW, Koh YI, Kim S, Kim SH, Nam YH, Jeong YY, Kim CW, Park HK, Kim SH, Kang HR, Jung JW. Unique Clinical Characteristics and Prognosis of Allopurinol-Induced Severe Cutaneous Adverse Reactions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2739-2749.e3. [DOI: 10.1016/j.jaip.2019.05.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/12/2019] [Accepted: 05/25/2019] [Indexed: 12/17/2022]
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29
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Wajda J, Dumnicka P, Maraj M, Ceranowicz P, Kuźniewski M, Kuśnierz-Cabala B. Potential Prognostic Markers of Acute Kidney Injury in the Early Phase of Acute Pancreatitis. Int J Mol Sci 2019; 20:E3714. [PMID: 31366007 PMCID: PMC6696144 DOI: 10.3390/ijms20153714] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/19/2019] [Accepted: 07/29/2019] [Indexed: 02/07/2023] Open
Abstract
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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Affiliation(s)
- Justyna Wajda
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, 31-034 Kraków, Poland
| | - Paulina Dumnicka
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Kraków, Poland
| | - Małgorzata Maraj
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, 31-531 Kraków, Poland
| | - Piotr Ceranowicz
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, 31-531 Kraków, Poland.
| | - Marek Kuźniewski
- Chair and Department of Nephrology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland
| | - Beata Kuśnierz-Cabala
- Department of Diagnostics, Chair of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland
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30
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Díaz de León-Martínez L, Díaz-Barriga F, Barbier O, Ortíz DLG, Ortega-Romero M, Pérez-Vázquez F, Flores-Ramírez R. Evaluation of emerging biomarkers of renal damage and exposure to aflatoxin-B 1 in Mexican indigenous women: a pilot study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:12205-12216. [PMID: 30835068 DOI: 10.1007/s11356-019-04634-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/19/2019] [Indexed: 05/18/2023]
Abstract
Aflatoxins (AFs) are mycotoxins produced by Aspergillus parasiticus and Aspergillus flavus which frequently contaminate maize. These compounds are considered toxic, especially AFB1 which has been classified as a human carcinogen, due to its relationship with the generation of hepatocellular carcinoma. Studies in vivo, in animal models, prove that chronic consumption of AFB1 has an association with renal adverse effects, but evidence in humans is scarce. Therefore, the main objective of this research was to conduct a pilot study to evaluate the correlation between exposure to AFB1 and early-stage renal damage in indigenous women of San Luis Potosí, Mexico. Exposure to AFB1 was measured through the biomarker AFB1-lysine and renal damage through kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin-C (Cys-C). AFB1-Lys was measured by HPLC-FLD. The method was validated with a correlation coefficient of 0.99 and limit of detection and quantification of 3.5 and 4.7 pg mL-1, respectively. Levels of NGAL, KIM-1, and Cys-C were determined (median (P25-P75), 5.96 (3.16-15.91), 0.137 (0.137-0.281), and 18.49 (5.76-29.57) ng mL-1, respectively). Additionally, glomerular filtration rate (GFR) (83.3 (59.8-107.4) mL/min/1.73 m2) and serum creatinine (SCr) (0.88 (0.72-1.22) mg dL-1) were obtained. The median concentrations for AFB1-Lys were 2.08 (1.89-5.8) pg mg-1 of albumin. Statistically significant correlations between AFB1-Lys/KIM-1 (Rho = 0.498, p = 0.007) and AFB1/Cys-C (Rho = 0.431, p = 0.014) were found. Our results indicate that women are exposed to AFB1, due to the fact that the AFB1-Lys biomarker was found in a high percentage of the study population (83%). In addition, the results of exposure to AFB1 show a strong significant correlation between KIM-1 and Cys-C that may indicate the toxic renal effect. These results are alarming because of the high toxicity of this compound and require adequate intervention to reduce AFB1 exposure in these populations.
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Affiliation(s)
- Lorena Díaz de León-Martínez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico
| | - Fernando Díaz-Barriga
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico
| | - Olivier Barbier
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico City, Mexico
| | - Dora Linda Guzmán Ortíz
- Departamento de Biotecnología y Bioquímica Centro de Investigación de Estudios Avanzados del -Instituto Politécnico Nacional (CINVESTAV-IPN), Campus Guanajuato, Irapuato, Mexico
| | - Manolo Ortega-Romero
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico City, Mexico
| | - Francisco Pérez-Vázquez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico
| | - Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico.
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Lee CW, Kou HW, Chou HS, Chou HH, Huang SF, Chang CH, Wu CH, Yu MC, Tsai HI. A combination of SOFA score and biomarkers gives a better prediction of septic AKI and in-hospital mortality in critically ill surgical patients: a pilot study. World J Emerg Surg 2018; 13:41. [PMID: 30214469 PMCID: PMC6131912 DOI: 10.1186/s13017-018-0202-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/27/2018] [Indexed: 12/17/2022] Open
Abstract
Background Sepsis is a syndrome characterized by a constellation of clinical manifestations and a significantly high mortality rate in the surgical intensive care unit (ICU). It is frequently complicated by acute kidney injury (AKI), which, in turn, increases the risk of mortality. Therefore, it is of paramount importance to identify those septic patients at risk for the development of AKI and mortality. The objective of this pilot study was to evaluate several different biomarkers, including NGAL, calprotectin, KIM-1, cystatin C, and GDF-15, along with SOFA scores, in predicting the development of septic AKI and associated in-hospital mortality in critically ill surgical patients. Methods Patients admitted to the surgical ICU were prospectively enrolled, having given signed informed consent. Their blood and urine samples were obtained and subjected to enzyme-linked immunosorbent assay (ELISA) to determine the levels of various novel biomarkers. The clinical data and survival outcome were recorded and analyzed. Results A total of 33 patients were enrolled in the study. Most patients received surgery prior to ICU admission, with abdominal surgery being the most common type of procedure (27 patients (81.8%)). In the study, 22 patients had a diagnosis of sepsis with varying degrees of AKI, while the remaining 11 were free of sepsis. Statistical analysis demonstrated that in patients with septic AKI versus those without, the following were significantly higher: serum NGAL (447.5 ± 35.7 ng/mL vs. 256.5 ± 31.8 ng/mL, P value 0.001), calprotectin (1030.3 ± 298.6 pg/mL vs. 248.1 ± 210.7 pg/mL, P value 0.049), urinary NGAL (434.2 ± 31.5 ng/mL vs. 208.3 ± 39.5 ng/mL, P value < 0.001), and SOFA score (11.5 ± 1.2 vs. 4.4 ± 0.5, P value < 0.001). On the other hand, serum NGAL (428.2 ± 32.3 ng/mL vs. 300.4 ± 44.3 ng/mL, P value 0.029) and urinary NGAL (422.3 ± 33.7 ng/mL vs. 230.8 ± 42.2 ng/mL, P value 0.001), together with SOFA scores (10.6 ± 1.4 vs. 5.6 ± 0.8, P value 0.003), were statistically higher in cases of in-hospital mortality. A combination of serum NGAL, urinary NGAL, and SOFA scores could predict in-hospital mortality with an AUROC of 0.911. Conclusions This pilot study demonstrated a promising panel that allows an early diagnosis, high sensitivity, and specificity and a prognostic value for septic AKI and in-hospital mortality in surgical ICU. Further study is warranted to validate our findings. Electronic supplementary material The online version of this article (10.1186/s13017-018-0202-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chao-Wei Lee
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China.,2College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,3Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China
| | - Hao-Wei Kou
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Hong-Shiue Chou
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Hsu-Huan Chou
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Song-Fong Huang
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Chih-Hsiang Chang
- Division of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
| | - Chun-Hsing Wu
- 3Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China
| | - Ming-Chin Yu
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China.,2College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China
| | - Hsin-I Tsai
- 3Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
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32
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Cambiaghi A, Díaz R, Martinez JB, Odena A, Brunelli L, Caironi P, Masson S, Baselli G, Ristagno G, Gattinoni L, de Oliveira E, Pastorelli R, Ferrario M. An Innovative Approach for The Integration of Proteomics and Metabolomics Data In Severe Septic Shock Patients Stratified for Mortality. Sci Rep 2018; 8:6681. [PMID: 29703925 PMCID: PMC5923340 DOI: 10.1038/s41598-018-25035-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/09/2018] [Indexed: 12/29/2022] Open
Abstract
In this work, we examined plasma metabolome, proteome and clinical features in patients with severe septic shock enrolled in the multicenter ALBIOS study. The objective was to identify changes in the levels of metabolites involved in septic shock progression and to integrate this information with the variation occurring in proteins and clinical data. Mass spectrometry-based targeted metabolomics and untargeted proteomics allowed us to quantify absolute metabolites concentration and relative proteins abundance. We computed the ratio D7/D1 to take into account their variation from day 1 (D1) to day 7 (D7) after shock diagnosis. Patients were divided into two groups according to 28-day mortality. Three different elastic net logistic regression models were built: one on metabolites only, one on metabolites and proteins and one to integrate metabolomics and proteomics data with clinical parameters. Linear discriminant analysis and Partial least squares Discriminant Analysis were also implemented. All the obtained models correctly classified the observations in the testing set. By looking at the variable importance (VIP) and the selected features, the integration of metabolomics with proteomics data showed the importance of circulating lipids and coagulation cascade in septic shock progression, thus capturing a further layer of biological information complementary to metabolomics information.
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Affiliation(s)
| | - Ramón Díaz
- Proteomics Platform - Parc Científic de Barcelona, Barcelona, Spain
| | | | - Antonia Odena
- Proteomics Platform - Parc Científic de Barcelona, Barcelona, Spain
| | - Laura Brunelli
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Pietro Caironi
- Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria S. Luigi Gonzaga, Orbassano, Italy.,Dipartimento di Oncologia, Università degli Studi di Torino, Turin, Italy
| | - Serge Masson
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | | | - Luciano Gattinoni
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany
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Beker BM, Corleto MG, Fieiras C, Musso CG. Novel acute kidney injury biomarkers: their characteristics, utility and concerns. Int Urol Nephrol 2018; 50:705-713. [PMID: 29307055 DOI: 10.1007/s11255-017-1781-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/22/2017] [Indexed: 12/16/2022]
Abstract
Acute kidney injury (AKI) consists of a rapid renal function decline which usually increases serum urea and creatinine levels. Since kidney injury begins by inducing biological and molecular changes which evolve to cellular damage, biomarkers could be used as tools for monitoring early AKI appearance, and predicting its recovery. Among the main AKI biomarkers the neutrophil gelatinase-associated lipocalin, cystatin C, kidney injury molecule-1, monocyte chemotactic peptide-1, N-acetyl-β-D-glucosaminidase, interleukin-18, liver-type fatty acid-binding protein, netrin-1, cycle arrest markers, endogenous ouabain, selenium-binding protein 1, and BPIFA2 marker, have been described. Even though novel biomarkers seem to be more helpful to early detect AKI and/or predict the need for renal replacement, and mortality compared to serum creatinine, more comprehensive studies are still required to determine their clinical utility.
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Affiliation(s)
- Braian M Beker
- Human Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mateo G Corleto
- Human Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Fieiras
- Human Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos G Musso
- Human Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
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