Study identifies biomarkers that can provide advance warning of deadly kidney condition

March 4, 2014, University of Pittsburgh Medical Center

A national, multi-center study led by University of Pittsburgh researchers found biomarkers that can tell a physician if a patient is at risk for acute kidney injury (AKI), a condition that often affects those in intensive care and can occur hours to days after serious infections, surgery or taking certain medications.

The results, now available online in the American Journal of Respiratory and Critical Care Medicine, validates previous research from this group identifying the , known as tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7) in urine, that signal the kidneys are stressed and at risk for failing. The biomarkers are indicators of cell damage, a key component in the onset of AKI.

"AKI remains one of the most common complications among , affecting up to 7 percent of all hospitalized patients, yet we lack a precise and reliable method of discerning risk," said senior investigator John Kellum, M.D., a physician at UPMC and director of the Pitt Center for Critical Care Nephrology. "By providing actionable information, this study advances the translation of biomarker technology into routine practice."

Investigators enrolled 420 critically ill patients. The primary analysis assessed the ability of the biomarkers to predict moderate to severe AKI within 12 hours of test measurement. To confirm the findings, a committee of three independent expert nephrologists who were blinded to the results of the test reviewed the cases to diagnose AKI.

AKI is asymptomatic, lacking warning signs such as pain, shortness of breath or other clinical symptoms, particularly in the early stages when intervention is most beneficial. The incidence of AKI is high among critically ill patients, with up to 50 percent developing some degree of AKI during their illness, increasing the risk of death due to kidney failure.

"This new study confirms these findings using an expert panel to adjudicate AKI—the first ever to do so for this disease," said Dr. Kellum.

Explore further: Hospitalized patients with acute kidney injury may not be receiving sufficient care after discharge

More information: "Validation of Cell-Cycle Arrest Biomarkers for Acute Kidney Injury Using Clinical Adjudication." Azra Bihorac, Lakhmir S Chawla, Andrew D Shaw, Ali Al-Khafaji, Danielle L Davison, George E DeMuth, Robert Fitzgerald, Michelle Ng Gong, Derrel D Graham, Kyle Gunnerson, Michael Heung, Saeed Jortani, Eric Kleerup, Jay L Koyner, Kenneth Krell, Jennifer LeTourneau, Matthew Lissauer, James Miner, H Bryant Nguyen, Luis M Ortega, Wesley H Self, Richard Sellman, Jing Shi, Joely Straseski, James E Szalados, Scott T Wilber, Michael G Walker, Jason Wilson, Richard Wunderink, Janice Zimmerman, and John A Kellum. American Journal of Respiratory and Critical Care Medicine, www.atsjournals.org/doi/abs/10 … -0077OC#.UxXkGPldXfL

Related Stories

Hospitalized patients with acute kidney injury may not be receiving sufficient care after discharge

November 7, 2013
Acute kidney injury (AKI) is the most common in-hospital diagnosis seen by US nephrologists, but patients with the condition may not be receiving sufficient follow-up care. That's the conclusion of a study that will be presented ...

Acute kidney injury may be more deadly than heart attacks

December 5, 2013
Acute kidney injury, a condition that is common but often asymptomatic, may be more deadly than a heart attack, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology ...

Biomarkers of kidney injury indicate increased risk of death after discharge from cardiac surgery

December 20, 2013
Following cardiac surgery, patients with elevated levels of kidney injury biomarkers are at a significantly higher risk of dying during the next three years, a Yale study has found. The results appear in the Journal of the ...

Acute kidney injury may be a risk factor for later heart problems

February 6, 2014
Patients who experience abrupt kidney injury following surgery have an increased risk of later developing heart problems, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology ...

Kidney injury not uncommon after cardiovascular intervention

January 22, 2014
(HealthDay)—Acute kidney injury (AKI) is seen in about 7 percent of patients undergoing percutaneous coronary intervention (PCI) and is associated with significant in-hospital mortality, according to research published ...

Study expands use of biomarker for early diagnosis of acute kidney injury

September 5, 2013
A biomarker test developed initially to identify early acute kidney injury (AKI) after surgery has been shown to successfully detect AKI in emergency room patients with a variety of urgent health issues.

Recommended for you

Infants born to obese mothers risk developing liver disease, obesity

November 16, 2018
Infant gut microbes altered by their mother's obesity can cause inflammation and other major changes within the baby, increasing the risk of obesity and non-alcoholic fatty liver disease later in life, according to researchers ...

New study shows NKT cell subsets play a large role in the advancement of NAFLD

November 16, 2018
Since 2015 it has been known that the gut microbiota could have a direct impact on nonalcoholic fatty liver disease (NAFLD), which affects up to 12% of adults and is a leading cause of chronic liver disease. In the November ...

Antibiotic prescribing influenced by team dynamics within hospitals

November 15, 2018
Antibiotic prescribing by doctors is influenced by team dynamics and cultures within hospitals.

Zika may hijack mother-fetus immunity route

November 14, 2018
To cross the placenta, Zika virus may hijack the route by which acquired immunity is transferred from mother to fetus, new research suggests.

New research aims to help improve uptake of hepatitis C testing

November 14, 2018
New research published in Scientific Reports shows persisting fears about HIV infection may impact testing uptake for the hepatitis C Virus (HCV).

Maternally acquired Zika immunity can increase dengue disease severity in mouse pups

November 14, 2018
To say that the immune system is complex is an understatement: an immune response protective in one context can turn deadly over time, as evidenced by numerous epidemiological studies on dengue infection, spanning multiple ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.