Diagnostic and short-term prognostic utility of plasma pro-enkephalin (pro-ENK) for acute kidney injury in patients admitted with sepsis in the emergency department

Abstract

Use of pro-ENK in septic patients can detect the presence and severity of AKI. Moreover, pro-ENK is highly predictive of short-term mortality and could enable early identification of patients at risk of death.

Acute ischemic stroke and severe multiorgan dysfunction due to multiple bee stings

“…In our opinion, acute renal failure may have resulted from rhabdomyolysis in our patient. Promising markers such as neutrophil gelatinase-associated lipocalin and pro-enkephalin may be useful in these patients to determine both presence and prognosis of renal failure 11, 12…”

Proenkephalin for the early detection of acute kidney injury in hospitalized patients with chronic kidney disease

“…This study showed a convincing sevenfold decrease in the requirement of renal replacement therapy and a 2.4fold decrease in mortality in patients receiving supportive therapy on the day of the alert compared to patients receiving delayed supportive therapy (day 1 or later). 10,15,19 We are therefore confident, that our baseline PENK results will apply to other populations. 23 Potential limitations of the current study merit consideration.…”

“…22 Of note, this intervention was based on the review of serial creatinine measurements, and the additional 24-hour window of opportunity provided delta PENK could potentially provide even bigger benefits. However, while recent data suggest, that including urine output criteria into the AKI definition might increase the AKI incidence, 24 most previously published studies assessing the predictive potential of AKI biomarkers in the non-ICU setting, also opted to exclude the urine output criteria for AKI diagnosis 10,15,25 as measuring urine output in a non-ICU setting is tedious and error prone. First, our study has a moderate number of patients and only few developed AKI.…”

“…The assay for stable PENK (molecular weight 4586 Da) was previously described 15 and has since been modified 16 (sphingotest ® penKid). After centrifugation, samples were frozen at −80°C until assayed in a blinded fashion in a single batch.…”

Acute Ischemic Stroke And Severe Multiorgan Dysfunction Due to Multiple Bee Stings

“…Promising markers such as neutrophil gelatinase-associated lipocalin and pro-enkephalin may be useful in these patients to determine both presence and prognosis of renal failure. 11,12 Reported cardiovascular complications of bee stings include acute myocardial infarction in patients with normal and abnormal coronary arteries. 13,14 We suggested that in our patient, ventricular dysrhythmia seems to be related to the release of vasoactive amines and thrombogenic substances that are in the hymenopterans venom, the former able to produce vasospasm, the latter able to ventricular dysrhythmia.…”