Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit*

Doi, Kent; Negishi, Kousuke; Ishizu, Tomoko; Katagiri, Daisuke; Fujita, Toshiro; Matsubara, Takehiro; Yahagi, Naoki; Sugaya, Takeshi; Noiri, Eisei

doi:10.1097/ccm.0b013e318225761a

Cited by 158 publications

(125 citation statements)

References 38 publications

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“…Lastly, urine Alb (uAlb) has also been investigated as an AKI biomarker. Matsui et al 57 found an AUC of 0.70 for uAlb regarding AKI prediction in a small study of 25 critically ill patients, while Doi et al 22 in a large study of 339 critically ill patients reported a similar AUC for uAlb (0.69). Another study found that uAlb in patients with prerenal AKI showed modest, but significantly higher concentrations than in patients with non-AKI.…”

Section: Kim-1 In the General Adult Icumentioning

confidence: 92%

“…ROC curve analysis revealed an AUC of 0.993 for death prediction. Likewise, Doi et al 22 found an AUC of 0.90 for 14-day mortality for uL-FABP measured on ICU admission. The AUC of uL-FABP for AKI prediction 1 week post-ICU entry was 0.75.…”

Section: Interleukin-18mentioning

confidence: 99%

“…62 NAG in the general adult ICU Westhuyzen et al 63 in a small prospective pilot study of 26 consecutive critically ill adult patients found that uNAG had an AUC of 0.84 for ARF prediction, while another small study by Matsui et al 57 reported an AUC of 0.63. Doi et al 22 in a large study of 339 critically ill patients found that uNAG was a moderate predictor of both AKI within 1 week after admission (AUC ¼ 0.62) and 14-day mortality (AUC ¼ 0.66). Another study found that uNAG in patients with pre-renal AKI showed modest, but significantly higher concentrations than in patients with non-AKI.…”

Section: Kim-1 In the General Adult Icumentioning

confidence: 99%

“…Moreover, the AUCs of uIL-18 for prediction of dialysis and death were 0.73 and 0.68, correspondingly. According to Doi et al 22 the AUCs of uIL-18 for AKI prediction within 1 week after admission and prediction of death 14 days post-entry were 0.69 and 0.83, respectively. In another study by Doi et al, 29 uIL-18 in patients with pre-renal AKI showed modest but significantly higher concentrations than in patients with non-AKI.…”

Section: Interleukin-18mentioning

confidence: 99%

“…An important finding of this study was that the performance of all biomarkers was improved by stratification for time of collection with respect to renal insult and for baseline renal function before injury. In another large prospective study, Doi et al 22 included 339 ICU patients, of whom 19% had AKI on admission according to RIFLE criteria. They compared the ability of five novel urine biomarkers [liver type-fatty acid-binding protein (L-FABP), N-Acetyl-β-D-Glucosaminidase (NAG), IL-18, NGAL, and albumin (Alb)] for AKI prediction.…”

Section: Ngal In the General Adult Icumentioning

confidence: 99%

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Novel Biomarkers of Acute Kidney Injury in the General Adult ICU: A Review

et al. 2013

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Acute kidney injury is one of the most frequent problems occurring in the critically ill patients of the intensive care units and it is well established that it increases both morbidity and mortality in these patients. Moreover, despite technological and pharmaceutical advances during the last decades, the incidence as well as the mortality associated with acute kidney injury in these patients remains unchanged. Creatinine, the most common renal dysfunction biomarker in use, has many disadvantages, such as time delay in its increase and the influence by other factors on its serum concentration, such as age, gender, muscle mass, etc. Hence, the need for better renal biomarkers in order to timely intervene for acute kidney injury prevention is imperative. The lack of an early biomarker is an obstacle for the development of new acute kidney injury prevention strategies. With the incidence of acute kidney injury reaching epidemic dimensions, the need for novel markers is urgent. During the last years, the research for finding such biomarkers has been intense. The purpose of the present article is to review the studies which have tested the predictive ability of those markers (in urine and/or plasma) for early detection of acute kidney injury in the mixed adult intensive care unit population and underline the potential limitations encountered in the various studies.

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Section: Kim-1 In the General Adult Icumentioning

confidence: 92%

Section: Interleukin-18mentioning

confidence: 99%

Section: Kim-1 In the General Adult Icumentioning

confidence: 99%

Section: Interleukin-18mentioning

confidence: 99%

Section: Ngal In the General Adult Icumentioning

confidence: 99%

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Novel Biomarkers of Acute Kidney Injury in the General Adult ICU: A Review

et al. 2013

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Urinary liver‐type fatty acid‐binding protein: A hemodynamic index during extracorporeal membrane oxygenation

Ichibayashi

Yamamoto

Nakamichi

et al. 2022

Clinical Case Reports

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Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is applied in circulatory failure cases such as cardiogenic shock, cardiac arrest, and refractory ventricular fibrillation. V-A ECMO management includes echocardiographic assessments of cardiac function and evaluations of the peripheral circulation based on venous oxygen saturation, lactate levels, regional cerebral oxygen saturation, and central venous pressure. ECMO flow rates exceeding cardiac output result in low pulse pressure, leading to low mean blood pressure. Thus, the mean blood pressure is also used to manage organ perfusion and peripheral circulation during ECMO support.Generally, urinary liver-type fatty acid-binding protein (L-FABP) is a useful clinical marker in the monitoring of chronic kidney disease (CKD). 1 And it can serve clinically as a predictive marker for contrast medium-induced nephropathy and acute kidney injury. 2,3 In addition, urinary L-FABP-a biomarker of renal ischemia-has also been considered to reflect acute systemic ischemic injury and to be effective in the assessment of sepsis treatment. 4,5 However, no reports have discussed urinary L-FABP use during V-A ECMO management in severe ischemic injury after cardiac arrest cases.Herein, we discuss a case in which urinary L-FABP measurements were used during V-A ECMO management. | CASE HISTORYHere, we describe a 46-year-old male patient who had collapsed at home in the presence of a close relative, who called for an ambulance and started resuscitation maneuvers until the arrival of the medical team. He has no medical history. The monitor waveform showed ventricular fibrillation requiring three defibrillation shocks, endo-tracheal intubation, and transport to our hospital. Extracorporeal cardiopulmonary resuscitation was initiated on arrival due to the onset of refractory ventricular fibrillation. The interval between the onset of cardiac arrest and V-A ECMO cannulation was 45 min. After starting V-A ECMO, defibrillation was performed once. The monitor waveform became pulseless electrical activity (PEA).

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Direct hemoperfusion using a polymyxin B‐immobilized polystyrene column for COVID‐19

Katagiri

Ishikane

Asai

et al. 2020

J of Clinical Apheresis

Self Cite

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Objective To evaluate the efficacy and safety of direct hemoperfusion using a polymyxin B‐immobilized polystyrene column (PMX‐DHP) in severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐positive pneumonia patients. Methods This study was a case series conducted at a designated infectious diseases hospital. Twelve SARS‐CoV‐2‐positive patients with partial pressure of arterial oxygen/percentage of inspired oxygen (P/F) ratio < 300 were treated with PMX‐DHP on two consecutive days each during hospitalization. We defined day 1 as the first day when PMX‐DHP was performed. PMX‐DHP efficacy was assessed on days 7 and 14 after the first treatment based on eight categories. Subsequently, improvement in P/F ratio and urinary biomarkers on days 4 and 8, malfunctions, and ventilator and extracorporeal membrane oxygenation avoidance rates were also evaluated. Results On day 14 after the first treatment, disease severity decreased in 58.3% of the patients. P/F ratio increased while urine β2‐microglobulin decreased on days 4 and 8. Cytokine measurement pre‐ and post‐PMX‐DHP revealed decreased levels of interleukin‐6 and the factors involved in vascular endothelial injury, including vascular endothelial growth factor. Twenty‐two PMX‐DHPs were performed, of which seven and five PMX‐DHPs led to increased inlet pressure and membrane coagulation, respectively. When the membranes coagulated, the circuitry needed to be reconfigured. Circuit problems were usually observed when D‐dimer and fibrin degradation product levels were high before PMX‐DHP. Conclusions Future studies are expected to determine the therapeutic effect of PMX‐DHP on COVID‐19. Because of the relatively high risk of circuit coagulation, coagulation capacity should be assessed beforehand.

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Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit*

Cited by 158 publications

References 38 publications

Novel Biomarkers of Acute Kidney Injury in the General Adult ICU: A Review

Novel Biomarkers of Acute Kidney Injury in the General Adult ICU: A Review

Urinary liver‐type fatty acid‐binding protein: A hemodynamic index during extracorporeal membrane oxygenation

Direct hemoperfusion using a polymyxin B‐immobilized polystyrene column for COVID‐19

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