New Biomarkers of Acute Kidney Injury and the Cardio-renal Syndrome

Hawkins, Robert C.

doi:10.3343/kjlm.2011.31.2.72

Cited by 50 publications

(51 citation statements)

References 97 publications

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“…In previous studies, NGAL was effective in the early diagnosis of acute kidney injury (AKI) in several clinical settings 25 and was also validated for its prognostic role in cardiovascular morbidity. 26,27 Cystatin C (CysC) is a small-molecular-weight protein and, in particular, an endogenous cysteine proteinase inhibitor highly correlated with GFR. 28 It is not influenced by inflammatory conditions, muscle mass, gender, body composition and age (after the age of 12 months).…”

Section: Introductionmentioning

confidence: 99%

NGAL and cystatin C: two possible early markers of diabetic nephropathy in young patients with type 1 diabetes mellitus: one year follow up

Papadopoulou-Marketou¹,

Skevaki²,

Kosteria³

et al. 2014

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OBJECTIVE: Diabetic nephropathy constitutes a major long-term complication in patients with type 1 diabetes mellitus (T1D) and its diagnosis is based on microalbuminuria. The aim of this observational follow-up study was to explore the role of neutrophil-gelatinase-associated lipocalin (NGAL) and cystatin C in unravelling early diabetic nephropathy even in patients with normoalbuminuria. DESIGN: Fifty-six euthyroid patients with T1D, with mean age 13.1 (SD: 3.2) years, and 49 healthy controls with mean age 12.8 (SD: 6.6) were recruited. Besides standard blood chemistry and urinary albumin excretion, serum NGAL (ELISA) and cystatin C (nephelometry) were measured at enrollment and after 12-15 months. GFR was calculated with the bedside Schwartz formula (eGFR) and the Lund strategy formula (L-eGFR). RESULTS: At baseline, mean NGAL levels were not significantly different between children with diabetes and controls. At re-evaluation, mean NGAL value and mean eGFR value in patients with diabetes were increased (p=0.032 and p=0.003 respectively). At both baseline and reevaluation, NGAL was positively correlated with cystatin C (r=0.41, p<0.001), systolic arterial pressure z-score (r=0.3, p=0.031) and creatinine (r=0.32, p=0.010). NGAL correlated negatively with eGFR (r=-0.26, p=0.049) and L-eGFR (r=-0.33, p=0.010). Cystatin C had a negative correlation to eGFR (r=-0.29, p=0.025) and a positive one with creatinine (r=0.35, p=0.009) at reevaluation. No statistically significant correlation was found between cystatin C and microalbuminuria (p=0.736). CONCLUSIONS: NGAL and cystatin C, known markers of renal injury, correlate with renal function decline in T1D, suggesting that they may be used as supplementary tests to urine albumin excretion in order to unmask early renal dysfunction.

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Section: Introductionmentioning

confidence: 99%

NGAL and cystatin C: two possible early markers of diabetic nephropathy in young patients with type 1 diabetes mellitus: one year follow up

Papadopoulou-Marketou¹,

Skevaki²,

Kosteria³

et al. 2014

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“…50,51 In some recent studies serum level of NGAL was found to be increased at the end of second trimester in women who subsequently developed PE compared to control group. 47,49,52 A positive correlation of serum NGAL was found with the systolic and diastolic blood pressure and with proteinuria. 38,47,49 Hence serum NGAL can be used as a reliable biomarker for early prediction of pre-eclampsia.…”

Section: Neutrophil Gelatinase-associated Lipocalin (Ngal)mentioning

confidence: 87%

“…48,49 It is also known as lipocalin-2, siderocalin, uterocalin and 24p3. 48,49 It was fi rst identifi ed as a matrix protein of specifi c granules of human neutrophils. Its expression is highly upregulated in damaged epithelial cells, during infl ammation, neoplastic conditions, cardiovascular diseases, infections and renal disorders.…”

Section: Neutrophil Gelatinase-associated Lipocalin (Ngal)mentioning

confidence: 99%

Novel Bio-Markers for Prediction of Preeclampsia

Garg

Singh

Dhiman

et al. 2016

Nepal j. obstet. gynaecol.

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Pre-eclampsia (PE) is a pregnancy related disorder. It is an important cause of maternal and perinatal morbidity and mortality worldwide. Two to eight percent of pregnancies were affected by PE. It is characterized by de novo hypertension and proteinuria after 20 weeks of gestation. The etiology and pathogenesis of the disease is unknown, but recent studies have revealed that placenta is the place of origin of this disorder and widespread maternal endothelial dysfunction is the characteristic feature of the disease. Some biochemical molecules are identified recently which are involved in the pathogenesis of the disease, which may help in early identification of patients at risk and help in providing proper prenatal care. Several promising biomarkers have been proposed, alone or in combination. Maternal serum concentrations of these biomarkers either increase or decrease in PE during gestation. This review focuses on the various biomarkers available and their utility in prediction and diagnosis of pre-eclampsia.

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“…There is a need for new specific biomarkers that identify kidney injury early and that can replace serum creatinine in both the definition of AKI for epidemiological and study purposes as well as in guiding individual patient management [5].…”

Section: -Fasting Plasma Glucose Level By Colorimetric Methodsmentioning

confidence: 99%

“…In AKI, serum creatinine elevation that reflects the development and severity of kidney damage does not occur until days after renal tubular injury has begun [4]; thus, there is a need for new specific biomarkers that identify kidney injury early and that can replace serum creatinine in both the definition of AKI for epidemiological and study purposes as well as in guiding individual patient management [5] Fatty acid binding proteins are small (15 kDa) cytoplasmatic proteins abundantly expressed in tissues with active fatty acid metabolism [6]. The liver type fatty acid binding protein is a newly emerging biomarker that has antioxidant properties, and enhanced expression in proximal tubule cells and subsequent urinary excretion are known to reflect the presence of tubular injury [7].…”

Section: Introductionmentioning

confidence: 99%

Urinary Liver Type-Fatty Acid Binding Protein and Plasma Cystatin C as Early Predictors of Contrast Induced Acute Kidney Injury

Lotfy¹,

Ismail²,

Shindy³

et al. 2013

Zagazig University Medical Journal

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Background: Contrast-induced acute kidney injury (CI-AKI) continues to have an increasing incidence, representing the third most common cause of hospital acquired acute kidney injury. It is a syndrome in which an acute renal dysfunction is diagnosed after the intravascular injection of contrast media. Acute renal injury is typically diagnosed by measuring serum creatinine that is an unreliable indicator during acute changes in kidney function; thus, the need for early sensitive biomarkers to detect acute kidney injury before the rise of creatinine has emerged. Urinary Liver type fatty acid binding protein is a newly emerging biomarker that might represent an early, sensitive and non-invasive biomarker for acute renal injury. Cystatin C is a cysteine protease inhibitor that demonstrated a high diagnostic value to detect AKI on the two days before creatinine elevation. Objective: The aim of our study was to elucidate if urinary L-FABP and plasma Cystatin C can be early predictors of AKI after contrast adminstration. Subject and methods: thirty three patients were included in this study, they were divided into two main groups; Group (I): 16 patients underwent coronary angiography for dioagnostic and therapeutic purposes, Group (II): 17 patients underwent computerized tomography using IV (high-osmolar) contrast media; then classified after the procedure to AKI group and Non AKI group according to the change in serum creatinine after 24 hours. Results: the basal value of both plasma cystatin c and urinary L-FABP is significantly higher in AKI vs non AKI groups indicating predictive value of both biomarkers before contrast exposure (AUC of urinary L-FABP = 0.837 (95%CI; 0.673 -1.001); AUC of plasma Cystatin C = 0.742 (95%CI; 0.600 -0.925)). After contrast exposure, both both plasma cystatin c and urinary L-FABP showed a highly statistically significiant elevation at 6 hours in the AKI group compared to the non AKI group, while there was no statistically significiant difference in serum creatinine (mg/dl) that showed significant elevation only after 24 hours; thus, both plasma cystatin c and urinary L-FABP may serve as early predictors of AKI after contrast adminstration before any significant change in serum creatinine (AUC of urinary L-FABP =1 (95%CI; 1 -1); AUC of plasma Cystatin C =1 (95%CI; 1 -1)). Conclusion: urinary L-FABP and plasma Cystatin C can be considered as predictive biomarkers of contrast induced nephropathy before contrast exposure and as early biomarkers after contrast exposure instead of serum creatinine, as their levels start to rise about 24 hours before any significant change in serum creatinine. Further studies are recommended using large number of patient.

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New Biomarkers of Acute Kidney Injury and the Cardio-renal Syndrome

Cited by 50 publications

References 97 publications

NGAL and cystatin C: two possible early markers of diabetic nephropathy in young patients with type 1 diabetes mellitus: one year follow up

NGAL and cystatin C: two possible early markers of diabetic nephropathy in young patients with type 1 diabetes mellitus: one year follow up

Novel Bio-Markers for Prediction of Preeclampsia

Urinary Liver Type-Fatty Acid Binding Protein and Plasma Cystatin C as Early Predictors of Contrast Induced Acute Kidney Injury

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