Acute Kidney Injury in Septic Patients Treated by Selected Nephrotoxic Antibiotic Agents—Pathophysiology and Biomarkers—A Review

Petejová, Naděžda; Martínek, Arnošt; Zadrazil, J; Káňová, Marcela; Klementa, Viktor; Šigutová, Radka; Kacířová, Ivana; Hrabovský, Vladimír; Švagera, Zdeněk; Stejskal, David

doi:10.3390/ijms21197115

Cited by 39 publications

(26 citation statements)

References 85 publications

(93 reference statements)

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“… 7 Urosepsis, which accounts for 5% of all sepsis, is a life-threatening organ dysfunction caused by urinary tract infection, and AKI is one of the most common organ injuries caused by urosepsis. 8 , 9 , 10 In this study, the incidence of urosepsis after URL surgery was 7.21%, of which the incidence of AKI was 22.9%, which was similar to the reported literature. Theoretically, removing blockages through the URL will allow the blocked side of the kidney to recover immediately and the overall kidney function will be better than before, but if sepsis occurs during the recovery phase, sequential organ dysfunction and infection of the kidney itself may significantly increase the risk of AKI.…”

Section: Discussionsupporting

confidence: 89%

Value of urine IL-8, NGAL and KIM-1 for the early diagnosis of acute kidney injury in patients with ureteroscopic lithotripsy related urosepsis

Tan¹,

Zhao²,

Peng³

et al. 2022

Chinese Journal of Traumatology

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Purpose To investigate the clinical value of urine interleukin-18 (IL-8), neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) for the early diagnosis of acute kidney injury (AKI) in patients with ureteroscopic lithotripsy (URL) related urosepsis. Methods A retrospective study was carried out in 157 patients with urosepsis after URL. The patients were divided into AKI group and non-AKI group according to the Kidigo guideline and urine IL-8, NGAL and KIM-1 levels were detected by enzyme-linked immunosorbent assay at 0, 4, 12, 24 and 48 h after the surgery. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of these three biomarkers for postoperative AKI. Results The level of urine IL-8, NGAL and KIM-1 in AKI group was significantly higher than that in non-AKI group at 4, 12, 24 and 48 h ( p < 0.01). The ROC analysis showed the combined detection of urine IL-8, NGAL and KIM-1 at 12 h had a larger area under curve (AUC) than a single marker (0.997, 95% CI : 0.991–0.998), and the sensitivity and specificity were 98.2% and 96.7%, respectively. Pearson correlation analysis showed that the levels of urine NGAL at 4, 12, 24 and 48 h in AKI patients were positively correlated with the levels of urine KIM-1 and IL-18 ( p < 0.01). Conclusion AKI could be quickly recognized by the elevated level of urine IL-8, NGAL and KIM-1 in patients with URL-related urosepsis. Combined detection of the three urine biomarkers at 12 h after surgery had a better diagnostic performance, which may be an important reference for the early diagnosis of AKI.

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Section: Discussionsupporting

confidence: 89%

Value of urine IL-8, NGAL and KIM-1 for the early diagnosis of acute kidney injury in patients with ureteroscopic lithotripsy related urosepsis

Tan¹,

Zhao²,

Peng³

et al. 2022

Chinese Journal of Traumatology

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“…These markers have been divided into; metabolomics, standard and serum biomarkers, urinary markers, experimentally associated markers and microRNAs (mRNAs). 45 In general, the diagnosis of AKI is based on the presence of elevated levels of serum urea and creatinine, in addition to the urine output of the patients. Kashaki et al have also reported the presence of other markers that are associated with AKI diagnosis.…”

Section: Reported Markers In Sepsis-associated Akimentioning

confidence: 99%

Overview of sepsis associated acute kidney injury: literature review

Al-Shahrani

Soofy

Mohammad

et al. 2021

Int J Community Med Public Health

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The incidence of acute kidney injury has been estimated to be around a fifth of the adult patients during their hospital stays. Sepsis is estimated to be the commonest cause for AKI development in critically-ill patients; contributing to the pathology in 20-50% of the cases. We reviewed some aspects of sepsis-associated AKI. Among the risk factors that may contribute to the development of AKI, age, sex, and the presence of comorbidities as diabetes, heart, and liver diseases were reported as significant factors associated with the development of the condition. The pathophysiology of sepsis-induced AKI is still unclear; however, some authors said that it may be related to the hypoperfusion of the renal tissue and subsequently induced ischemia. This theory was supported by animal studies; however, other investigations on humans reported no association between the two events. On the other hand, we believe that sepsis-induced AKI is probably due to the associated severe inflammatory state and hemodynamic instability are the main accusants. The management of this condition requires early diagnosis and early intervention by managing sepsis. Moreover, vasopressors as epinephrines have proved efficient in managing the shock state, even better than renal replacement therapy.

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“…An essential strategy for resolving this disappointing situation is identifying the agents or factors that potentially cause or precipitate AKI in clinical practice to prevent subsequent AKI. The use of drugs is a modifiable risk factor for AKI and is responsible for around 18%-40% of AKI among critically ill patients [5], while antibiotics are crucial triggers of AKI among all drugs [6].…”

Section: Introductionmentioning

confidence: 99%

Vancomycin-Associated Acute Kidney Injury: A Narrative Review from Pathophysiology to Clinical Application

Chen

Shiao

2022

IJMS

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Vancomycin is the most frequently used antibiotic, accounting for up to 35% of hospitalized patients with infection, because of its optimal bactericidal effectiveness and relatively low price. Vancomycin-associated AKI (VA-AKI) is a clinically relevant but not yet clearly understood entity in critically ill patients. The current review comprehensively summarizes the pathophysiological mechanisms of, biomarkers for, preventive strategies for, and some crucial issues with VA-AKI. The pathological manifestations of VA-AKI include acute tubular necrosis, acute tubulointerstitial nephritis (ATIN), and intratubular crystal obstruction. The proposed pathological mechanisms of VA-AKI include oxidative stress and allergic reactions induced by vancomycin and vancomycin-associated tubular casts. Concomitant administration with other nephrotoxic antibiotics, such as piperacillin–tazobactam, high vancomycin doses, and intermittent infusion strategies compared to the continuous infusion are associated with a higher risk of VA-AKI. Several biomarkers could be applied to predict and diagnose VA-AKI. To date, no promising therapy is available. Oral steroids could be considered for patients with ATIN, whereas hemodialysis might be applied to remove vancomycin from the patient. In the future, disclosing more promising biomarkers that could precisely identify populations susceptible to VA-AKI and detect VA-AKI occurrence early on, and developing pharmacological agents that could prevent or treat VA-AKI, are the keys to improve the prognoses of patients with severe infection who probably need vancomycin therapy.

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Acute Kidney Injury in Septic Patients Treated by Selected Nephrotoxic Antibiotic Agents—Pathophysiology and Biomarkers—A Review

Cited by 39 publications

References 85 publications

Value of urine IL-8, NGAL and KIM-1 for the early diagnosis of acute kidney injury in patients with ureteroscopic lithotripsy related urosepsis

Value of urine IL-8, NGAL and KIM-1 for the early diagnosis of acute kidney injury in patients with ureteroscopic lithotripsy related urosepsis

Overview of sepsis associated acute kidney injury: literature review

Vancomycin-Associated Acute Kidney Injury: A Narrative Review from Pathophysiology to Clinical Application

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