Urinary Biomarkers for Early Detection of Recovery in Patients with Acute Kidney Injury

Moon, Sung Jin; Park, Hyung Bok; Yoon, Soo Young; Lee, Sang Choel

doi:10.3346/jkms.2013.28.8.1181

Cited by 25 publications

(22 citation statements)

References 34 publications

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“…(48) AKI was defined as a 50% or greater increase in plasma creatinine from baseline. AKI recovery was defined as a 50% or greater decrease in plasma creatinine from the peak level.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of renal recovery after acute kidney injury

Gaião¹,

Paiva²

2017

Revista Brasileira De Terapia Intensiva

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Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery. The reference lists of these articles and relevant review articles were also reviewed. Final references were selected for inclusion in the review based on their relevance. New biomarkers exhibited a potential role in the early diagnosis of acute kidney injury recovery. Urine HGF, IGFBP-7, TIMP-2 and NGAL may improve our ability to predict the odds and timing of recovery and eventually renal support withdrawal. Acute kidney injury recovery requires more study, and its definition needs to be standardized to allow for better and more powerful research on biomarkers because some of them show potential for the prediction of acute kidney injury recovery.

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“…(48) AKI was defined as a 50% or greater increase in plasma creatinine from baseline. AKI recovery was defined as a 50% or greater decrease in plasma creatinine from the peak level.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of renal recovery after acute kidney injury

Gaião¹,

Paiva²

2017

Revista Brasileira De Terapia Intensiva

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“…In our previously published data, the plasmatic value was restricted to 450 ng/mL [2]. For the urinary level, it was suggested that a value of NGAL higher than 348.2 mg/dl (sensitivity 0.84 and specificity 0.69) is a potential indicator of higher risk of mortality [15,19].…”

Section: Resultsmentioning

confidence: 99%

The Postoperative Plasmatic Level of Neutrophil Gelatinase-associated Lipocalin Does not Reflect its Tissue Expression in Critically ill Patients with High Abdominal Pressure

Puiac¹,

Jung²,

Puşcaşiu³

et al. 2018

Rev. Chim.

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The aim of this study was to evaluate the correlation between serum and tissue level of the Neutrophil gelatinase-associated lipocalin (NGAL), a peptide that seems to be predict the postoperative evolution of patients with high abdominal pressure. From 30 consecutive patients hospitalized in the Intensive Care Unit, we have randomly selected five cases that undergo abdominal surgical interventions, received postoperative mechanical ventilation and abdominal pressure was monitorized for at least 48 hours. In all of these cases, the plasmatic level of NGAL was measured using the Elisa method and immunohistochemical (IHC) stains with the anti-NGAL biomarker were performed in the surgically removed tissues. All of the five patients were overweight, showed high serum level of NGAL (over 950 ng/ml) and died with postoperative or septic shock. The NGAL serum level was not correlated with the abdominal pressure. No IHC positivity was observed in the examined tissues, except NGAL positivity for intravascular neutrophils. In conclusion, the postoperative high serum NGAL level may indicate unfavorable evolution. NGAL seems to be syntesized by the circulating neutrophils and its preoperative tissue expression does not reflect the serum value.

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“…Although several biomarkers described above have been explored and reported for the early diagnosis of AKI, other biomarkers have lower specificity and sensitivity for AKI diagnosis than NGAL protein, and their time used for diagnosis is also longer than NGAL protein [1, 9, 14–17, 22, 23]. The level of NGAL protein rapidly increased in the blood and urine during the very early stage of AKI, and it can distinguish prerenal and renal AKI [24], and the level of NGAL protein in urine could be an independent predictor which can reflect the status of recovery from AKI [25]. Taken together, NGAL protein meets the criteria of ideal biomarkers for AKI diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Development of a novel ssDNA aptamer targeting neutrophil gelatinase-associated lipocalin and its application in clinical trials

et al. 2019

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Background Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of early diagnosis and prediction for acute kidney injury (AKI). However, the current program for NGAL detection is not extensively applied in clinics due to the high expense of antibodies. Nucleic acid aptamers are single-strand DNAs or RNAs which could bind to targets with high specificity and affinity, and they have been widely used in the diagnosis and therapy for multiple diseases. It is valuable for us to develop a new method for NGAL detection using aptamers instead of antibodies to achieve increased efficiency and decreased cost. Methods Nucleic acid aptamers against NGAL were obtained after SELEX process using magnetic beads, and an enzyme-linked aptamer analysis (ELAA), which can be widely used in clinical diagnosis at low cost, were successfully established. The feasibility of ELAA was further validated with urine samples harvested from 43 AKI patients and 30 healthy people. Results Three candidate aptamers, including NA36, NA42 and NA53, were obtained after 8 rounds of SELEX process with magnetic beads and verified by quantitative polymerase chain reaction (qPCR), and the Kd value of each aptamer was 43.59, 66.55 and 32.52 nM, respectively. Moreover, the linear relationship was consistent at the range of 125–4000 ng/mL, and the detection limit of ELAA assay was 30.45 ng/mL. We also found that NGAL could be exclusively detected with NA53, and no cross-reaction between NA53 and human albumin or globulin occurred, the coefficient of variation (CV) between inner-plate and inter-plate was less than 15%, and the recovery rate was between 80 and 110%. Moreover, the sensitivity and specificity of ELAA assay in this study are 100% and 90%, respectively. Consistently, these results could also diagnose whether the occurrence of AKI in lots of patients, which has been demonstrated with the ELAA method we established after using NA53. Conclusions Taken together, NA53, the best candidate aptamer targeting NGAL protein, can be applied in clinical testing. Electronic supplementary material The online version of this article (10.1186/s12967-019-1955-7) contains supplementary material, which is available to authorized users.

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Urinary Biomarkers for Early Detection of Recovery in Patients with Acute Kidney Injury

Cited by 25 publications

References 34 publications

Biomarkers of renal recovery after acute kidney injury

Biomarkers of renal recovery after acute kidney injury

The Postoperative Plasmatic Level of Neutrophil Gelatinase-associated Lipocalin Does not Reflect its Tissue Expression in Critically ill Patients with High Abdominal Pressure

Development of a novel ssDNA aptamer targeting neutrophil gelatinase-associated lipocalin and its application in clinical trials

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