Proenkephalin, Renal Dysfunction, and Prognosis in Patients With Acute Heart Failure

Abstract

PENK levels reflect cardiorenal status in acute HF and are prognostic for worsening renal function and in-hospital mortality as well as mortality during follow-up.

Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

“…A recent consensus conference provided a framework for the reclassification of AKI along changes in functional (sCr and UO) and damage or stress biomarkers (Figure ) . Over the past decade, several biomarkers of AKI have demonstrated the ability to detect kidney injury or stress and have been proposed as tools to improve the evaluation and treatment of patients with AKI …”

“…Importantly, damage may occur before reaching the AKI threshold of changes in sCr or UO, reflecting delay in the kinetics of these functional markers or the presence of renal reserve (the compensatory ability of the kidney to increase GFR in the face of increased demand). The best‐studied and most widely available biomarkers in the clinical setting are urinary or plasma NGAL and TIMP2·IGFBP7 . NGAL has been most successful in pediatric cardiac surgery, whereas TIMP2·IGFBP7 has been used in both adult and pediatric cases.…”

“…84 Over the past decade, several biomarkers of AKI have demonstrated the ability to detect kidney injury or stress and have been proposed as tools to improve the evaluation and treatment of patients with AKI. 67,[85][86][87][88][89][90][91][92] Importantly, damage may occur before reaching the AKI threshold of changes in sCr or UO, reflecting delay in the kinetics of these functional markers or the presence of renal reserve (the compensatory ability of the kidney to increase GFR in the face of increased demand). The best-studied and most widely available biomarkers in the clinical setting are urinary or plasma NGAL and TIMP2ÁIGFBP7.…”

“…The best-studied and most widely available biomarkers in the clinical setting are urinary or plasma NGAL and TIMP2ÁIGFBP7. 67,[85][86][87][88][89][90][91][92][93] NGAL has been most successful in pediatric cardiac surgery, whereas TIMP2ÁIGFBP7 has been used in both adult and pediatric cases. Thus, biomarkers may potentially refine the clinical management of AKI by providing both diagnostic and prognostic information independent of the conventional functional markers of AKI.…”

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.…”