Biomarkers in Cardiorenal Syndrome and Potential Insights Into Novel Therapeutics

Chung, Edmund Y. M.; Trinh, Katie; Li, Jennifer; Hahn, Sebastian Hayden; Endre, Z. H.; Rogers, Natasha M.; Alexander, Stephen I.

doi:10.3389/fcvm.2022.868658

Cited by 16 publications

(8 citation statements)

References 119 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is assumed that it may be associated with the activation of immune cells [ 202 ]. After the stimulation of dendritic cells and macrophages, which took place during aldosterone excess, the synthesis of NGAL increased and led to the fibrosis of blood vessels and the development of hypertension [ 203 , 204 , 205 ]. Moreover, as NGAL is an important biomarker of renal dysfunction, it may be helpful to detect kidney damage in the early stages of kidney failure in hypertensive individuals [ 206 ].…”

Section: The Role Of Ngal In Cardiovascular Diseasesmentioning

confidence: 99%

The Review of Current Knowledge on Neutrophil Gelatinase-Associated Lipocalin (NGAL)

Romejko¹,

Markowska²,

Niemczyk³

2023

IJMS

View full text Add to dashboard Cite

Neutrophil gelatinase-associated lipocalin (NGAL) is a 25-kDa protein that is secreted mostly by immune cells such as neutrophils, macrophages, and dendritic cells. Its production is stimulated in response to inflammation. The concentrations of NGAL can be measured in plasma, urine, and biological fluids such as peritoneal effluent. NGAL is known mainly as a biomarker of acute kidney injury and is released after tubular damage and during renal regeneration processes. NGAL is also elevated in chronic kidney disease and dialysis patients. It may play a role as a predictor of the progression of renal function decreases with complications and mortality due to kidney failure. NGAL is also useful in the diagnostic processes of cardiovascular diseases. It is highly expressed in injured heart tissue and atherosclerostic plaque; its serum concentrations correlate with the severity of heart failure and coronary artery disease. NGAL increases inflammatory states and its levels rise in arterial hypertension, obesity, diabetes, and metabolic complications such as insulin resistance, and is also involved in carcinogenesis. In this review, we present the current knowledge on NGAL and its involvement in different pathologies, especially its role in renal and cardiovascular diseases.

show abstract

Section: The Role Of Ngal In Cardiovascular Diseasesmentioning

confidence: 99%

The Review of Current Knowledge on Neutrophil Gelatinase-Associated Lipocalin (NGAL)

Romejko¹,

Markowska²,

Niemczyk³

2023

IJMS

View full text Add to dashboard Cite

show abstract

“…Щодо п'ятирічної виживаності, наші дані також збігаються з результатами дослідження A. Atici et al [17], які не підтвердили переваги KIM-1 у прогнозуванні кардіоренального синдрому при декомпенсованій ХСН. Крім того, у роботі E. Y. M. Chung et al не доведено роль маркера КІМ-1 у сечі під час прогнозування стійкого порушення функції нирок або смертності від усіх причин у пацієнтів із гострою декомпенсованою серцевою недостатністю [18]. Прогностична користь КІМ-1 не доведена й у дослідженні за участю хворих на ХСН [13].…”

Section: оригінальні дослідженняunclassified

The impact of renal tubulointerstitial dysfunction on the early and long-term prognosis in chronic heart failure patients with preserved left ventricular ejection fraction

Syvolap,

Lysenko,

Svitlyi

2024

Pathologia

View full text Add to dashboard Cite

Aim. To study the dependence of the early-term (1 year) and long-term (5 years) prognosis in patients with chronic heart failure (CHF) of ischemic origin with preserved left ventricular ejection fraction (LVEF) depending on renal tubulointerstitial functional disorders. Materials and methods. The study involved 88 patients (men – 46.6 % (n = 41); women – 53.4 % (n = 47)) with CHF of ischemic origin, stage II A–B, stage II–IV according to NYHA, 67 % (n = 59) with sinus rhythm, and 33 % (n = 29) with atrial fibrillation. Patients with sinus rhythm and atrial fibrillation were matched in age (p = 0.483), height (p = 0.345), weight (p = 0.317), body surface area (p = 0.153). NGAL levels were analyzed using an ELISA kit (E-EL-H0096, Elabscience, USA). NAG levels were analyzed using an ELISA kit (SEA 069 Hu, Cloud-Clone Corp., USA). KIM-1 levels were analyzed using an ELISA kit (SEA 785 Hu, Cloud-Clone Corp., USA). Kaplan–Meier curves and Cox proportional hazards regression analysis were performed. Results. No significant difference was found in the frequency of the cumulative endpoint during the first-year follow-up from the initial level of two markers of tubulointerstitial injury – KIM-1 (Log-Rank Test: p = 0.57529) and NAG (Log-Rank Test: p = 0.86001). According to the results of analysis of the Cox proportional hazards, only a tendency to increase in the risk factors of adverse events were observed in case of elevated KIM-1 (HR = 1.66; p = 0.5795) and NAG levels (HR = 1.1712; p = 0.8626) in this CHF patients’ cohort. Kaplan–Meier analysis revealed a probable (Log-Rank Test; p = 0.00141) increase in the frequency of the cumulative endpoint during the first year of follow-up in CHF patients with preserved LVEF due to increased serum NGAL level more than 168 ng/ml. According to the univariate model, an elevated serum NGAL level is associated with an increase in the relative risk by 4.2 times (95 % CI 1.78–16.89; p = 0.014). A reduced sodium level less than 142.5 mmol/l was associated with an increase in number of adverse cardiovascular events during the first-year follow- ups by 22 % (HR = 1.22, p = 0.029). After 5 years of follow-up, a decrease in sodium level less than 142.3 mmol/l is also characterized by a probable difference of the cumulative Kaplan–Meier’s curves (Cox–Mantel F-Test, p = 0.00287). According to the univariate model of Cox proportional hazards, the relative risk of adverse cardiovascular events in patients with CHF during the 5-year follow-up has a tendency to increase by 1.04 times (95 % CI 0.85–1.27; p = 0.72). Serum NGAL, a marker of renal tubulo-interstitial injury, doesn’t lose its properties as a powerful marker of an unfavorable long-term prognosis in patients with CHF with preserved LVEF (HR = 5.96; 95 % CI 1.17–30.50; p = 0.032). Conclusions. The most powerful factors of the early (1-year) prognosis of adverse cardiovascular events in CHF patients with preserved left ventricular ejection fraction are the marker of tubulointerstitial injury, serum NGAL over 168 ng/ml, as well as the marker of tubulointerstitial dysfunction – the serum sodium level less than 142.5 mmol/l. The electrolyte imbalance, decreased sodium level less than 142.3 mmol/l, remains a powerful marker of an unfavorable long-term 5-year prognosis in CHF patients with preserved left ventricular ejection fraction, meanwhile serum NGAL, a marker of renal tubulointerstitial injury, besides doesn’t lose its prognostic value (HR = 5.96; 95 % CI 1.17–30.50; p = 0.032), but also is independent from the parameters of the age (p = 0.409) and gender (p = 0.397) in such patients.

show abstract

“…29 Kidney damage and stress biomarkers detect AKI many hours prior to serum creatinine elevation and have been extensively reviewed in multiple contexts. [30][31][32][33][34][35] As discussed, damage and stress biomarkers provide clues to activated pathophysiological pathways (Figure 3).…”

Section: Pathophysiology Of Aki and Potential Mechanism-specific Biom...mentioning

confidence: 99%

Definitions, phenotypes, and subphenotypes in acute kidney injury—Moving towards precision medicine

Rodrigues

Endre

2022

Nephrology

View full text Add to dashboard Cite

The current definition of acute kidney injury (AKI) is generic and, based only on markers of function, is unsuitable for guiding individualized treatment. AKI is a complex syndrome with multiple presentations and causes. Targeted AKI management will only be possible if different phenotypes and subphenotypes of AKI are recognised, based on causation and related pathophysiology. Molecular signatures to identify subphenotypes are being recognised, as specific biomarkers reveal activated pathways. Assessment of individual clinical risk needs wider dissemination to allow identification of patients at high risk of AKI. New and more timely markers for glomerular filtration rate (GFR) are available. However, AKI diagnosis and classification should not be limited to GFR, but include tubular function and damage. Combining damage and stress biomarkers with functional markers enhances risk prediction, and identifies a population enriched for clinical trials targeting AKI. We review novel developments and aim to encourage implementation of these new techniques into clinical practice as a strategy for individualizing AKI treatment akin to a precision medicine-based approach.

show abstract

Biomarkers in Cardiorenal Syndrome and Potential Insights Into Novel Therapeutics

Cited by 16 publications

References 119 publications

The Review of Current Knowledge on Neutrophil Gelatinase-Associated Lipocalin (NGAL)

The Review of Current Knowledge on Neutrophil Gelatinase-Associated Lipocalin (NGAL)

The impact of renal tubulointerstitial dysfunction on the early and long-term prognosis in chronic heart failure patients with preserved left ventricular ejection fraction

Definitions, phenotypes, and subphenotypes in acute kidney injury—Moving towards precision medicine

Contact Info

Product

Resources

About