NGAL, L-FABP, and KIM-1 in comparison to established markers of renal dysfunction

Holzscheiter, Leon; Beck, Claus; Rutz, Sandra; Manuilova, Ekaterina; Domke, Ingrid; Guder, W. G.; Hofmann, Walter

doi:10.1515/cclm-2013-0693

Cited by 40 publications

(36 citation statements)

References 28 publications

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“…[32][33][34] Also inflammatory comorbidities such as urinary tract infections and sepsis can serve as confounders, as inflammation results in systemic release of NGAL derived from other organs as well. 35 Moreover, even though urinary NGAL levels were increased in preterm neonates with sCrdocumented AKI, NGAL levels did not predict AKI prior to its development. 36 In general, these biomarkers represent upregulated protein levels during renal injury which are derived from specific segments of the nephron.…”

Section: Discussionmentioning

confidence: 95%

Tubular Injury Biomarkers to Detect Gentamicin-Induced Acute Kidney Injury in the Neonatal Intensive Care Unit

et al. 2015

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Section: Discussionmentioning

confidence: 95%

Tubular Injury Biomarkers to Detect Gentamicin-Induced Acute Kidney Injury in the Neonatal Intensive Care Unit

et al. 2015

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“…These new variables could include circulating or urine biomarkers, systemic or kidney hemodynamics, and imaging markers. Neutrophil gelatinaseassociated lipocalin, interleukin-18, kidney injury molecule-1, L-fatty acid binding protein, and cystatin C are the most-known relevant biomarkers that have been used in AKI risk prediction [25][26][27]. Recent advances in methodologies to assess physiological biomarkers reflecting systemic or kidney hemodynamics were lately reviewed by the Acute Dialysis Quality Improvement (ADQI) workgroup [28].…”

Section: Discussionmentioning

confidence: 99%

Application of 17 Contrast-Induced Acute Kidney Injury Risk Prediction Models

et al. 2020

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Introduction: Contrast-induced acute kidney injury (CI-AKI) is a frequent complication of percutaneous coronary interventions (PCI). Various groups have developed and validated risk scores for CI-AKI. Although the majority of these risk scores achieve an adequate accuracy, their usability in clinical practice is limited and greatly debated. Objective: With the present study, we aimed to prospectively assess the diagnostic performance of recently published CI-AKI risk scores (up to 2018) in a cohort of patients undergoing PCI. Methods: We enrolled 1,247 consecutive patients (80% men, mean age 62 ± 10 years) treated with elective or urgent PCI. For each patient, we calculated the individual CI-AKI risk score based on 17 different risk models. CI-AKI was defined as an increase of ≥25% (liberal) or ≥0.5 mg/dL (strict) in pre-PCI serum creatinine 48 h after PCI. Results: CI-AKI definition and, therefore, CI-AKI incidence have a significant impact on risk model performance (median negative predictive value increased from 85 to 99%; median c-statistic increased from 0.516 to 0.603 using more strict definition criteria). All of the 17 published models were characterized by a weak-to-moderate discriminating ability mainly based on the identification of "true-negative" cases (median positive predictive value 19% with liberal criterion and 3% with strict criterion). In none of the models, c-statistic was > 0.800 with either CI-AKI definition. Novel, different combinations of the > 35 independent variables used in the published models either by down-or by up-scaling did not result in significant improvement in predictive performance. Conclusions: The predictive ability of all models was similar and only modest, derived mainly by identifying true-negative cases. A new approach is probably needed by adding novel markers or periprocedural characteristics.

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“…Neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) are promising candidates to detect kidney injuries in the early stages. These proteins are expressed by renal tubules, and clinical investigations have shown that they are massively expressed in cases of AKI in both adults and children [ 203 , 205 , 207 , 208 , 213 – 217 ]. NGAL concentrations seem to correlate with the severity/stage of CKD [ 204 ].…”

Section: Kidney Function and Its Impact On Drugs In Pediatric Patientmentioning

confidence: 99%

Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children

et al. 2015

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Neonates, infants, and children differ from adults in many aspects, not just in age, weight, and body composition. Growth, maturation and environmental factors affect drug kinetics, response and dosing in pediatric patients. Almost 80 % of drugs have not been studied in children, and dosing of these drugs is derived from adult doses by adjusting for body weight/size. As developmental and maturational changes are complex processes, such simplified methods may result in subtherapeutic effects or adverse events. Kidney function is impaired during the first 2 years of life as a result of normal growth and development. Reduced kidney function during childhood has an impact not only on renal clearance but also on absorption, distribution, metabolism and nonrenal clearance of drugs. ‘Omics’-based technologies, such as proteomics and metabolomics, can be leveraged to uncover novel markers for kidney function during normal development, acute kidney injury, and chronic diseases. Pharmacometric modeling and simulation can be applied to simplify the design of pediatric investigations, characterize the effects of kidney function on drug exposure and response, and fine-tune dosing in pediatric patients, especially in those with impaired kidney function. One case study of amikacin dosing in neonates with reduced kidney function is presented. Collaborative efforts between clinicians and scientists in academia, industry, and regulatory agencies are required to evaluate new renal biomarkers, collect and share prospective pharmacokinetic, genetic and clinical data, build integrated pharmacometric models for key drugs, optimize and standardize dosing strategies, develop bedside decision tools, and enhance labels of drugs utilized in neonates, infants, and children.

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NGAL, L-FABP, and KIM-1 in comparison to established markers of renal dysfunction

Cited by 40 publications

References 28 publications

Tubular Injury Biomarkers to Detect Gentamicin-Induced Acute Kidney Injury in the Neonatal Intensive Care Unit

Tubular Injury Biomarkers to Detect Gentamicin-Induced Acute Kidney Injury in the Neonatal Intensive Care Unit

Application of 17 Contrast-Induced Acute Kidney Injury Risk Prediction Models

Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children

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