Urinary Liver-Type Fatty Acid-Binding Protein Linked with Increased Risk of Acute Kidney Injury after Allogeneic Stem Cell Transplantation

Shingai, Naoki; Morito, Taku; Najima, Yuho; Igarashi, Aiko; Kobayashi, Takeshi; Doki, Noriko; Kakihana, Kazuhiko; Ohashi, Kazuteru; Ando, Minoru

doi:10.1016/j.bbmt.2014.08.022

Cited by 24 publications

(21 citation statements)

References 33 publications

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“…This study suggests that more precise and suitable investigations are warranted to detect hidden mild kidney injury at baseline, for instance, using sensitive new urinary biomarkers. 30 AKI following SCT is reported to be a risk factor for CKD. 8,31 The Gray's analysis showed an association of early AKI with the incidence of CKD in this study.…”

Section: Discussionmentioning

confidence: 99%

Early-onset acute kidney injury is a poor prognostic sign for allogeneic SCT recipients

Shingai

Morito

Najima

et al. 2015

Bone Marrow Transplant

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Acute kidney injury (AKI) following stem-cell transplantation (SCT) contributes to a poor prognosis, yet its impact may vary depending on the timing of AKI onset. A prospective cohort study was performed to understand the significance of the onset timing in 103 allogeneic SCT (allo-SCT) recipients. AKI prior to stem-cell engraftment was defined as early AKI and subsequently occurring AKI as late AKI. Propensity score (PS) for early AKI was calculated using a logistic regression model to reduce confounding effects related to differences in clinical background between the early and late AKI groups. The cumulative incidences of early and late AKI were 22.3% and 54.9%, respectively. Non-relapse mortality (NRM) was 39.1% and 7.0%, and overall survival (OS) was 56.5% and 90.9% in early and late AKI at 100 days after AKI, respectively (Po 0.001). The cumulative incidence of chronic kidney disease (CKD) over 2 years after SCT was 41.5% and 19.1% in early and late AKI, respectively (P = 0.048). Logistic regression analysis adjusted for the PS showed that early AKI was significantly associated with OS (odds ratio (95% confidence interval); 4.63 (1.15-21.4), P = 0.031) but with neither NRM (1.25 (0.28-5.33), P = 0.766) nor CKD (1.85 (0.41-8.60), P = 0.422). In conclusion, early AKI may portend a poor survival for allo-SCT recipients.

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Section: Discussionmentioning

confidence: 99%

Early-onset acute kidney injury is a poor prognostic sign for allogeneic SCT recipients

Shingai

Morito

Najima

et al. 2015

Bone Marrow Transplant

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“…Urinary L-FABP can predict the onset of AKI after cardiac surgery [13,49,50], pediatric cardiopulmonary bypass [17], stem cell transplantation [12], and endovascular and open-abdominal aortic aneurysm repair [16] as well as in intensive care unit populations [15]. Additionally, L-FABP can also predict the progression to end-stage renal disease (ESRD), the onset of cardiovascular disease (CVD), or death for patients with AKI [14,51], type 2 diabetes [8,52], or chronic kidney a b Fig.…”

Section: Predicting Poor Outcomesmentioning

confidence: 99%

“…L-FABP has been shown to be a useful urinary biomarker for the diagnosis of renal disease in the following clinical conditions: diabetic nephropathy [6][7][8][9], anemia [10], acute kidney injury (AKI) [11][12][13][14][15][16], pediatric AKI [17], contrast medium-induced nephropathy [18,19], IgA nephropathy [20], human immunodeficiency virus (HIV)-associated nephropathy [21,22], and reduced graft function in renal transplantation [23,24]. Numerous AKI cohort studies have reported increased urinary levels of L-FABP in patients with septic shockinduced AKI [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Urinary excretion of liver-type fatty acid-binding protein reflects the severity of sepsis

et al. 2017

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Sepsis due to microbial invasion often causes multiple organ failure (MOF), including acute kidney injury (AKI), with high mortality rates in serious cases. Hence, there is an urgent need for diagnostic biomarkers that can be used to rapidly, accurately, and easily detect sepsis to identify the condition early and guide the selection of appropriate treatment. Liver-type fatty acid-binding protein (L-FABP), which localizes in renal proximal tubules, is excreted into the urine in response to oxidative stress-induced tubular injury. Because of this mechanism, L-FABP has been reported to be a useful urinary biomarker not only for renal disease but also for the severity of sepsis. Based on this concept, we developed a new L-FABP point-of-care (POC) assay kit that can be used to rapidly measure human L-FABP in the urine to further improve the usefulness of this biomarker in clinical settings. In this review, we describe the molecular mechanisms of L-FABP, its clinical usefulness, and the performance of the POC assay kit.

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“…21 Furthermore, a recent prospective cohort study showed an increased risk of AKI following allogeneic HCT associated with an increase in urinary liver-type fatty acid-binding protein preceding preconditioning therapy. 22 Nevertheless, the clinical applicability of single biomarkers is still lacking solid evidence.…”

Section: Definition and Diagnosismentioning

confidence: 99%

Acute kidney injury in HCT: an update

Lopes

Jorge

Neves

2016

Bone Marrow Transplant

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Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative hematopoietic cell transplantation (HCT); however, the pathogenesis and risk factors leading to AKI can differ between the two. The prognosis of AKI in patients receiving HCT is poor. In fact, AKI following HCT is associated not only with increased short-and long-term mortality, but also with progression to chronic kidney disease. Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis, as well as of the incidence, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and non-myeloablative regimens. INTRODUCTIONHematopoietic cell transplantation (HCT) is currently used to treat numerous malignant (for example, multiple myeloma, leukemias and lymphomas) and non-malignant hematological disorders (for example, aplastic anemia, b-thalassemia, immunodeficiency disorders and inborn errors of metabolism), as well as solid tumors (for example, breast cancer and neuroblastoma), which are in other instances incurable.The two major HCT procedures, taking into consideration the conditioning regimen used, are myeloablative autologous and allogeneic HCT and non-myeloablative allogeneic HCT. On the one hand, myeloablative HCT utilizes the maximally tolerated dose of TBI with or without chemotherapy, or with chemotherapy alone. On the other hand, non-myeloablative HCT depends more on donor cellular immune effects and less on the cytotoxic effects of the preparative regimen to control the underlying disease. 1,2 It ultimately uses a lower dose conditioning regimen and can thus be offered to older patients, to those debilitated by additional comorbidities, or to high-risk, heavily pretreated patients, who would not tolerate myeloablative HCT, resulting in a consequent decrease in regimen-related toxicity and treatment-related mortality. [3][4][5] Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative regimens; however, the pathogenesis and risk factors leading to AKI can differ between the two. In fact, AKI in patients receiving HCT is associated not only with increased short-and long-term mortality as compared with patients with no AKI, but also with a higher rate of progression to chronic kidney disease (CKD). Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis of AKI as well as of the incidence, risk factors, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and nonmyeloablative regimens.

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Urinary Liver-Type Fatty Acid-Binding Protein Linked with Increased Risk of Acute Kidney Injury after Allogeneic Stem Cell Transplantation

Cited by 24 publications

References 33 publications

Early-onset acute kidney injury is a poor prognostic sign for allogeneic SCT recipients

Early-onset acute kidney injury is a poor prognostic sign for allogeneic SCT recipients

Urinary excretion of liver-type fatty acid-binding protein reflects the severity of sepsis

Acute kidney injury in HCT: an update

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