Early Prediction of Acute Renal Injury Using Urinary Proteomics

Abstract

Aims: The lack of early biomarkers for acute renal failure (ARF) has crippled our ability to launch potentially effective therapeutic measures. We tested the hypothesis that urinary proteomics could identify novel early biomarker patterns for ischemic renal injury. Methods: Sixty patients undergoing cardiopulmonary bypass (CPB) were enrolled. Urine samples obtained at 2 and 6 h post CPB were analyzed by Surface-Enhanced Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (SELDI-TOF-MS). The primary outcome variable was ARF, defined as a 50% or greater increase in serum creatinine. Results: Fifteen patients (25%) developed ARF 2–3 days after CPB. SELDI-TOF-MS analysis of urine from the ARF group at baseline versus at 2 and 6 h post-CPB consistently showed a marked and statistically significant enhancement of protein biomarkers with m/z of 6.4, 28.5, 43 and 66 kDa. The same biomarkers were enhanced when comparing control versus ARF groups at 2 and 6 h post-CPB. The sensitivity and specificity of the 28.5-, 43- and 66-kDa biomarkers for the prediction of ARF at 2 h following CPB was 100%. The receiver operating characteristic curves revealed an area under the curve of 0.98. Conclusion: SELDI-TOF-MS is a novel, non-invasive, sensitive, highly predictive, reproducible, rapid method for the prediction of acute renal injury following CPB.

Human body fluid proteome analysis

“…Distinct urinary proteomic patterns, as obtained by CE-MS, SELDI-MS, or label-free LC-MS profiling, have been demonstrated for early detection of renal diseases/complications [306][307][308][309]. In a CE-MS study, 16 differentially excreted polypeptides formed a pattern as early indicators of graft-versus-host disease (GVHD), allowing discrimination of GVHD from patients without complications with 82% specificity and 100% sensitivity (crossvalidation) [307].…”

Urine Neutrophil Gelatinase-Associated Lipocalin and Interleukin-18 Predict Acute Kidney Injury after Cardiac Surgery

“…(Note that the study on AKI in cardiac surgery children has already been mentioned this hypothesis. [21] ) Recently, the studies of early biomarkers for AKI hypothesized cohort candidates, such as kidney injury molecule 1, [14,24] kidney-specific adhesion molecule, sodium-hydrogen exchanger isoform 3, interleukin 6, interleukin 8, cystatin C, and so on. Some got a conflicting and unsatisfactory result, while most showed optimistic results.…”

Genomic technologies in neonatology

“…В частно-сти, такие дети находятся в группах высокого риска по развитию острой почечной недостаточности, даль-нейшему формированию хронической почечной пато-логии и артериальной гипертензии. Ряд исследовате-лей сообщают об использовании OMICS-технологии в прогнозировании рисков развития почечной недо-статочности [44][45][46]. Наблюдение за новорожденными с воспалительными заболеваниями кишечника должно осуществляться в тесной взаимосвязи неонатологов с гастроэнтерологами, инфекционистами, иммуноло-гами, поскольку современные исследования все боль-ше подтверждают геномные, иммуномные и микро-биотические причины этих состояний [34,[47][48][49].…”