Performance of urinary NGAL and L-FABP in predicting acute kidney injury and subsequent renal recovery: a cohort study based on major surgeries

Zeng, Xianfei; Li, Junmin; Tan, Yun; Wang, Zhufeng; He, Yong; Chang, Jiang; Zhang, Hong; Zhao, Hua; Bai, Xiao; Xie, Fei; Sun, Juan; Zhang, Yan

doi:10.1515/cclm-2013-0823

Cited by 36 publications

(31 citation statements)

References 36 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, earlier identification of patients who have not fulfilled the diagnosis of AKI may permit physicians to take appropriate actions. To date, the following biomarkers have been validated for early detection of AKI: sCysC, serum and urine neutrophil gelatinase-associated lipocalin [23,24], kidney injury molecule 1 [25], urinary insulin-like growth factor-binding protein 7 [26], and urinary interleukin 18 [27]. Among these, sCysC is reportedly an early biomarker for diagnosing AKI in patients receiving cardiac surgery [22,28], with liver cirrhosis [29] or sepsis [24].…”

Section: Discussionmentioning

confidence: 99%

Incidence, Risk factors, and Biomarkers Predicting Ischemic or Hemorrhagic Stroke Associated Acute Kidney Injury and Outcome: A Retrospective Study in a General Intensive Care Unit

Jiang

Xiang

et al. 2019

Blood Purif

View full text Add to dashboard Cite

Objective: We investigated the epidemiology, risk factors, and predictive parameters for ischemic or hemorrhagic stroke-associated acute kidney injury (AKI) and mortality in a general intensive care unit (ICU) in China. Methods: During 5 years, 479 stroke patients were screened, and 381 were enrolled. AKI was diagnosed within 7 days after ICU admission, based on the Kidney Disease Improving Global Outcomes criteria. Risk factors of AKI were assessed by Logistic regression analyses, and the predictive biomarkers for AKI were determined using receiver operating characteristic (ROC) curves. Also examined were factors influencing 28-day mortality, using Cox regression analyses and Kaplan-Meier curves. Results: Among all, 115 (30.18%) patients developed AKI. Multivariate regression analyses revealed that the following features at ICU admission significantly increased the risk of developing AKI: an increased National Institutes of Health Stroke Scale score (OR 1.136, p < 0.001) and Acute Physiology and Chronic Health Evaluation II score (OR 1.107, p = 0.042); hypertension (OR 2.346, p = 0.008); use of loop diuretics (OR 1.961, p = 0.032); and higher serum cystatin C (sCysC; OR 8.156, p = 0.001). The area under the ROC curves for predicting AKI using sCysC was 0.772, slightly better than that of other biomarkers. The sCysC ≥0.93 mg/L (hazard ratio 1.844, p = 0.004) significantly predicted 28-day mortality. Conclusions: Among stroke patients in ICU, we identified significant risk factors of stroke-associated AKI. Serum CysC level at ICU admission was an important biomarker for predicting AKI and 28-day mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Incidence, Risk factors, and Biomarkers Predicting Ischemic or Hemorrhagic Stroke Associated Acute Kidney Injury and Outcome: A Retrospective Study in a General Intensive Care Unit

Jiang

Xiang

et al. 2019

Blood Purif

View full text Add to dashboard Cite

show abstract

“…This study clearly highlights the value of repeated measures over single values. KIM-1 and L-FABP have also been proposed as a marker of renal recovery after AKI [35, 36]. Similarly the product of the more recently described G 1 cell cycle arrest markers of renal stress TIMP-2 and IGFBP7 ([TIMP-2] × [IGFBP7]) predicted short-term renal recovery/non-recovery within 48 h in 57 patients with early AKI [37].…”

Section: Clinical Definition Of Renal Recoverymentioning

confidence: 99%

Renal recovery after acute kidney injury

et al. 2017

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short- and long-term mortality, chronic kidney disease (CKD) and cardiovascular events. The degree of renal recovery from AKI may substantially affect these long-term endpoints. Therefore maximising recovery of renal function should be the goal of any AKI prevention and treatment strategy. Defining renal recovery is far from straightforward due in part to the limitations of the tests available to assess renal function. Here, we discuss common pitfalls in the evaluation of renal recovery and provide suggestions for improved assessment in the future. We review the epidemiology of renal recovery and of the association between AKI and the development of CKD. Finally, we stress the importance of post-discharge follow-up of AKI patients and make suggestions for its incorporation into clinical practice. Summary key points are that risk factors for non-recovery of AKI are age, CKD, comorbidity, higher severity of AKI and acute disease scores. Second, AKI and CKD are mutually related and seem to have a common denominator. Third, despite its limitations full recovery of AKI may best be defined as the absence of AKI criteria, and partial recovery as a fall in AKI stage. Fourth, after an episode of AKI, serial follow-up measurements of serum creatinine and proteinuria are warranted to diagnose renal impairment and prevent further progression. Measures to promote recovery are similar to those preventing renal harm. Specific interventions promoting repair are still experimental.

show abstract

“…In a recent study of critically ill patients, urinary L-FABP improved the predictive capability of a clinical prediction model for AKI progression, dialysis, or death within 7 days among patients with early AKI [116]. In addition, among patients undergoing major surgery, Zeng et al described the use of NGAL and L-FABP as a promising combination that may improve the diagnostic performance of AKI detection, although the investigators found this panel of biomarkers to be a poor predictor of renal recovery after AKI [117]. In summary, urinary L-FABP appears to be a promising biomarker for both diagnosis and prediction of AKI and its outcomes among critically ill patients [118].…”

Section: Kidney Injury Moleculementioning

confidence: 99%

Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption

Kashani

Cheungpasitporn

Ronco

2017

Clinical Chemistry and Laboratory Medicine (CCLM)

241

197

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a common complication of critical illnesses and has a significant impact on outcomes, including mortality and morbidities. Unfortunately, apart from prophylactic measures, no effective treatment for this syndrome is known. Therefore, early recognition of AKI not only can provide better opportunities for preventive interventions, but also opens many gates for research and development of effective therapeutic options. Over the last few years, several new AKI biomarkers have been discovered and validated to improve early detection, differential diagnosis, and differentiation of patients into risk groups for progressive renal failure, need for renal replacement therapy (RRT), or death. These novel AKI biomarkers complement serum creatinine (SCr) and urine output, which are the standard diagnostic tools for AKI detection. In this article, we review the available literature on characteristics of promising AKI biomarkers that are currently the focus of preclinical and clinical investigations. These biomarkers include neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), liver-type fatty acid-binding protein, interleukin 18 (lL-18), insulin-like growth factor-binding protein 7, tissue inhibitor of metalloproteinase 2 (TIMP-2), calprotectin, urine angiotensinogen (AGT), and urine microRNA. We then describe the clinical performance of these biomarkers for diagnosis and prognostication. We also appraise each AKI biomarker's advantages and limitations as a tool for early AKI recognition and prediction of clinical outcomes after AKI. Finally, we review the current and future states of implementation of biomarkers in the clinical practice.

show abstract

Performance of urinary NGAL and L-FABP in predicting acute kidney injury and subsequent renal recovery: a cohort study based on major surgeries

Abstract: Urinary NGAL and L-FABP can be used to detect AKI and combining NGAL and L-FABP may improve the diagnostic performance; however, NGAL and L-FABP may be poor predictors for renal recovery after AKI.

Cited by 36 publications

References 36 publications

Incidence, Risk factors, and Biomarkers Predicting Ischemic or Hemorrhagic Stroke Associated Acute Kidney Injury and Outcome: A Retrospective Study in a General Intensive Care Unit

Incidence, Risk factors, and Biomarkers Predicting Ischemic or Hemorrhagic Stroke Associated Acute Kidney Injury and Outcome: A Retrospective Study in a General Intensive Care Unit

Renal recovery after acute kidney injury

Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption

Contact Info

Product

Resources

About