Study: Biomarkers May Predict Acute Kidney Injury in Critically Ill Patients
An international, multi-center study led by UPMC researchers—including McGowan Institute for Regenerative Medicine affiliated faculty member John Kellum, MD, a critical care physician at UPMC and professor of critical care at the University of Pittsburgh—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 after serious infections, surgery, or taking certain medications. The results, now available online and published in the journal Critical Care, provide insight into the potentially deadly condition that affects up to 7 percent of all hospitalized patients.
Existing methods of determining kidney function, such as measuring serum creatinine and urine output, may not indicate changes for several days, allowing time for significant kidney damage to occur. Biomarkers, which are naturally occurring proteins or other molecules in the blood, urine, or other body fluids or tissues, may help physicians more accurately determine the risk of AKI in critically ill patients so that early treatment can minimize progression and save lives.
“If unchecked, AKI can lead to loss of kidney function, often resulting in lower quality of life or even death. Our data show that these biomarkers provide more information than traditional tests for kidney function and give us a better understanding of what physically happens when a kidney is damaged,” said senior investigator Dr. Kellum.
AKI risk is difficult to determine because the condition is typically caused by something outside of the kidney, including sepsis, nephrotoxins, and oxygen deprivation. The study aimed to identify early markers in order to detect AKI when interventions could provide benefit. Researchers collected blood and urine samples of more than 1,000 critically ill patients in North America and Europe. The biomarkers, known as TIMP-2 and IGFB7, signal that the kidneys are stressed and not functioning properly but may still recover. They are indicators of cell damage, a key component in the onset of AKI.
“These biomarkers send an early ‘alarm’ from the site of the injury and offer a better chance at treatment that can prevent further damage,” Dr. Kellum said.
Co-authors of the study include researchers from 35 medical centers worldwide.
Abstract (Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. J Kellum, et al. Critical Care 2013, 17:R25, 6 February 2013.)