A current view on the early diagnosis and treatment of acute kidney failure

Rozas, Bastian Abarca; Rodríguez, Manuel Mestas; Isea, Jorge Widerström; Pareja, Beatriz Lobos; Urra, Jocelyn Vargas

doi:10.5867/medwave.2020.05.7928

Cited by 8 publications

(12 citation statements)

References 24 publications

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“…Timely recognition enables interventions that can potentially mitigate the progression of kidney injury, attenuate organ dysfunction, and improve patient outcomes [ 21 ]. Prompt identification allows for the implementation of strategies, such as fluid resuscitation, optimization of hemodynamics, and targeted antimicrobial therapy, which can significantly impact the course of AKI and SAKI [ 22 , 23 ]. Furthermore, early detection facilitates the implementation of renal protective measures and personalized treatment plans tailored to individual patients, optimizing the management of these conditions [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prompt identification allows for the implementation of strategies, such as fluid resuscitation, optimization of hemodynamics, and targeted antimicrobial therapy, which can significantly impact the course of AKI and SAKI [ 22 , 23 ]. Furthermore, early detection facilitates the implementation of renal protective measures and personalized treatment plans tailored to individual patients, optimizing the management of these conditions [ 22 , 23 ]. In our study, we investigated the potential of plasma and urine levels of CCL2 as biomarkers for differentiating AKI patients from non-AKI patients in the ICU, as well as distinguishing SAKI from non-septic AKI.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of urine CCL2 as a potential diagnostic biomarker for acute kidney injury and septic acute kidney injury in intensive care unit patients

Peng,

Wang,

Jin

et al. 2024

Renal Failure

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Acute kidney injury (AKI) is a prevalent and serious condition in the intensive care unit (ICU), associated with significant morbidity and mortality. Septic acute kidney injury (SAKI) contributes substantially to AKI cases in the ICU. However, current diagnostic methods have limitations, necessitating the exploration of novel biomarkers. In this study, we investigated the potential of plasma and urine CCL2 levels as diagnostic markers for AKI and SAKI in 216 ICU patients. Our findings revealed significant differences in plasma ( p < 0.01) and urine CCL2 ( p < 0.0001) levels between AKI and non-AKI patients in the ICU. Notably, urine CCL2 demonstrated promising predictive value for AKI, exhibiting high specificity and sensitivity (AUC = 0.8976; p < 0.0001). Furthermore, we observed higher urine CCL2 levels in SAKI compared to non-septic AKI ( p < 0.001) and urine CCL2 could also differentiate SAKI from non-septic AKI (AUC = 0.7597; p < 0.0001). These results suggest that urine CCL2 levels hold promise as early biomarkers for AKI and SAKI, offering valuable insights for timely intervention and improved management of ICU patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of urine CCL2 as a potential diagnostic biomarker for acute kidney injury and septic acute kidney injury in intensive care unit patients

Peng,

Wang,

Jin

et al. 2024

Renal Failure

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“…The de nition of AKI, HRS-AKI, and other clinical events We used the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines to de ne AKI as the presence of one of the following criteria: (1) serum creatinine (sCr) increase by ≥ 0.3 mg/dL (≥ 26.5 µmol/L) within 48 h; (2) sCr increase by ≥ 50% from baseline value within the previous 1 week; and (3) decreased urine volume as ≤ 0.5 mL/kg/h for at least 6 h 29 . HRS-AKI was diagnosed according to the revised de nition based on the International Club of Ascites (ICA) consensus document as follows: 8 (1) diagnosis of cirrhosis, acute liver failure, or acute-onchronic liver failure; (2) presence of AKI according to the ICA consensus document (consistent with the KDIGO de nition); (3) no response for at least 48 h of diuretic withdrawal and volume expansion with albumin by 1 g/kg body weight/day to a maximum of 100 g/day; (4) absence of shock; (5) no recent or current exposure to nephrotoxic drugs; and (6) no evidence of structural kidney disease de ned as proteinuria < 500 mg/day, microhematuria (< 50 red blood cells per high-power eld), normal urinary injury biomarkers (if available), and/or normal renal ultrasonography. The de nitions of the other clinical events are shown in Supplementary Table S1 30,31 .…”

Section: Introductionmentioning

confidence: 99%

“…AKI and HRS, especially HRS-AKI, are associated with increased mortality, the need for intensive care, and hospital readmission in patients with cirrhosis 4 . The early identi cation of AKI and HRS is important to the prompt management and prevention of disease progression 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Prediction models combining zonulin, LPS, and LBP predict acute kidney injury and hepatorenal syndrome–acute kidney injury in cirrhotic patients

Lin

Kuo

Shen

et al. 2023

Preprint

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The development of acute kidney injury (AKI) and hepatorenal syndrome-acute kidney injury (HRS-AKI) in cirrhosis has been associated with intestinal barrier dysfunction and gut-kidney crosstalk. We use the related markers such as zonulin, lipopolysaccharides (LPS), and lipopolysaccharide-binding protein (LBP) to predict AKI and HRS-AKI in cirrhotic patients and evaluate their in vitro effects on intestinal (Caco-2) cells and renal tubular (HK-2) cells. From 2013 to 2020, we enrolled 70 cirrhotic patients and developed prediction models for AKI and HRS-AKI over a six-month period. There were 13 (18.6%) and 8 (11.4%) cirrhotic patients who developed AKI and HRS-AKI. The prediction models incorporated zonulin, LPS, LBP, C-reactive protein, age, and history of hepatitis B for AKI, and zonulin, LPS, LBP, total bilirubin, and Child-Pugh score for HRS-AKI. The area under curve (AUC) for the prediction of AKI and HRS-AKI was 0.94 and 0.95, respectively. Furthermore, the conditioned medium of LPS + hrLBP pre-treated Caco-2 cells induced apoptosis, necrosis, and zonulin release in HK-2 cells, demonstrating the communication between them. This study found that zonulin, LPS, and LBP are potential practical markers for predicting AKI and HRS-AKI in cirrhotic patients, which may serve as potential targets for renal outcomes in cirrhotic patients.

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“…AKI and HRS, especially HRS–AKI, are associated with increased mortality, the need for intensive care, and hospital readmission in patients with cirrhosis 4 . The early identification of AKI and HRS is important to the prompt management and prevention of disease progression 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Prediction models combining zonulin, LPS, and LBP predict acute kidney injury and hepatorenal syndrome–acute kidney injury in cirrhotic patients

Lin

Kuo

Shen

et al. 2023

Sci Rep

View full text Add to dashboard Cite

The development of acute kidney injury (AKI) and hepatorenal syndrome–acute kidney injury (HRS–AKI) in cirrhosis has been associated with intestinal barrier dysfunction and gut-kidney crosstalk. We use the related markers such as zonulin, lipopolysaccharides (LPS), and lipopolysaccharide-binding protein (LBP) to predict AKI and HRS–AKI in cirrhotic patients and evaluate their in vitro effects on intestinal (Caco-2) cells and renal tubular (HK-2) cells. From 2013 to 2020, we enrolled 70 cirrhotic patients and developed prediction models for AKI and HRS–AKI over a six-month period. There were 13 (18.6%) and 8 (11.4%) cirrhotic patients developed AKI and HRS–AKI. The prediction models incorporated zonulin, LPS, LBP, C-reactive protein, age, and history of hepatitis B for AKI, and zonulin, LPS, LBP, total bilirubin, and Child–Pugh score for HRS–AKI. The area under curve (AUC) for the prediction of AKI and HRS–AKI was 0.94 and 0.95, respectively. Furthermore, the conditioned medium of LPS+hrLBP pre-treated Caco-2 cells induced apoptosis, necrosis, and zonulin release in HK-2 cells, demonstrating the communication between them. This study found that zonulin, LPS, and LBP are potential practical markers for predicting AKI and HRS–AKI in cirrhotic patients, which may serve as potential targets for renal outcomes in cirrhotic patients.

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A current view on the early diagnosis and treatment of acute kidney failure

Cited by 8 publications

References 24 publications

Assessment of urine CCL2 as a potential diagnostic biomarker for acute kidney injury and septic acute kidney injury in intensive care unit patients

Assessment of urine CCL2 as a potential diagnostic biomarker for acute kidney injury and septic acute kidney injury in intensive care unit patients

Prediction models combining zonulin, LPS, and LBP predict acute kidney injury and hepatorenal syndrome–acute kidney injury in cirrhotic patients

Prediction models combining zonulin, LPS, and LBP predict acute kidney injury and hepatorenal syndrome–acute kidney injury in cirrhotic patients

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