Cargando…
Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy
Background: Identifying acute kidney injury (AKI) within few hours of onset is certainly helpful. However, early prediction of a long-term eGFR decline may be an even more important goal. Our aim was to identify and compare serum [creatinine, kineticGFR, cystatin C, neutrophil gelatinase–associated...
Autores principales: | , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135876/ https://www.ncbi.nlm.nih.gov/pubmed/37189664 http://dx.doi.org/10.3390/biomedicines11041046 |
_version_ | 1785032085313945600 |
---|---|
author | Allinovi, Marco Sessa, Francesco Villa, Gianluca Cocci, Andrea Innocenti, Samantha Zanazzi, Maria Tofani, Lorenzo Paparella, Laura Curi, Dritan Cirami, Calogero Lino Campi, Riccardo Mari, Andrea Ognibene, Agostino Lorubbio, Maria Fanelli, Alessandra Romagnoli, Stefano Romagnani, Paola Minervini, Andrea |
author_facet | Allinovi, Marco Sessa, Francesco Villa, Gianluca Cocci, Andrea Innocenti, Samantha Zanazzi, Maria Tofani, Lorenzo Paparella, Laura Curi, Dritan Cirami, Calogero Lino Campi, Riccardo Mari, Andrea Ognibene, Agostino Lorubbio, Maria Fanelli, Alessandra Romagnoli, Stefano Romagnani, Paola Minervini, Andrea |
author_sort | Allinovi, Marco |
collection | PubMed |
description | Background: Identifying acute kidney injury (AKI) within few hours of onset is certainly helpful. However, early prediction of a long-term eGFR decline may be an even more important goal. Our aim was to identify and compare serum [creatinine, kineticGFR, cystatin C, neutrophil gelatinase–associated lipocalin (NGAL)] and urinary (NephroCheck, NGAL, proteinuria, albuminuria, acantocytes at urinary sediment) predictors of AKI that might efficiently predict long-term GFR decline after robotic Nephron-Spearing Surgery (rNSS). Methods: Monocentric prospective observational study. Patients scheduled for rNSS for suspected localized Renal Cell Carcinoma from May 2017 to October 2017 were enrolled. Samples were collected preoperatively and postoperatively (timepoints: 4 h, 10 h, 24 h, 48 h), while kidney function was re-assessed up to 24 months. Results: 38 patients were included; 16 (42%) developed clinical AKI. The eGFR decline at 24 months was more pronounced after postoperative AKI (−20.75 vs. −7.20, p < 0.0001). KineticGFR at 4 h (p = 0.008) and NephroCheck at 10 h (p = 0.001) were, at multivariable linear regression analysis, efficient predictors of post-operative AKI and long-term eGFR decline if compared to creatinine (R2 0.33 vs. 0.04). Conclusions: NephroCheck and kineticGFR have emerged as promising noninvasive, accurate, and early biomarkers of postoperative AKI and long-term GFR decline after rNSS. Combining NephroCheck and kineticGFR in clinical practice would allow to identify high risk of postoperative AKI and long-term GFR decline as early as 10 h after surgery. |
format | Online Article Text |
id | pubmed-10135876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101358762023-04-28 Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy Allinovi, Marco Sessa, Francesco Villa, Gianluca Cocci, Andrea Innocenti, Samantha Zanazzi, Maria Tofani, Lorenzo Paparella, Laura Curi, Dritan Cirami, Calogero Lino Campi, Riccardo Mari, Andrea Ognibene, Agostino Lorubbio, Maria Fanelli, Alessandra Romagnoli, Stefano Romagnani, Paola Minervini, Andrea Biomedicines Article Background: Identifying acute kidney injury (AKI) within few hours of onset is certainly helpful. However, early prediction of a long-term eGFR decline may be an even more important goal. Our aim was to identify and compare serum [creatinine, kineticGFR, cystatin C, neutrophil gelatinase–associated lipocalin (NGAL)] and urinary (NephroCheck, NGAL, proteinuria, albuminuria, acantocytes at urinary sediment) predictors of AKI that might efficiently predict long-term GFR decline after robotic Nephron-Spearing Surgery (rNSS). Methods: Monocentric prospective observational study. Patients scheduled for rNSS for suspected localized Renal Cell Carcinoma from May 2017 to October 2017 were enrolled. Samples were collected preoperatively and postoperatively (timepoints: 4 h, 10 h, 24 h, 48 h), while kidney function was re-assessed up to 24 months. Results: 38 patients were included; 16 (42%) developed clinical AKI. The eGFR decline at 24 months was more pronounced after postoperative AKI (−20.75 vs. −7.20, p < 0.0001). KineticGFR at 4 h (p = 0.008) and NephroCheck at 10 h (p = 0.001) were, at multivariable linear regression analysis, efficient predictors of post-operative AKI and long-term eGFR decline if compared to creatinine (R2 0.33 vs. 0.04). Conclusions: NephroCheck and kineticGFR have emerged as promising noninvasive, accurate, and early biomarkers of postoperative AKI and long-term GFR decline after rNSS. Combining NephroCheck and kineticGFR in clinical practice would allow to identify high risk of postoperative AKI and long-term GFR decline as early as 10 h after surgery. MDPI 2023-03-28 /pmc/articles/PMC10135876/ /pubmed/37189664 http://dx.doi.org/10.3390/biomedicines11041046 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Allinovi, Marco Sessa, Francesco Villa, Gianluca Cocci, Andrea Innocenti, Samantha Zanazzi, Maria Tofani, Lorenzo Paparella, Laura Curi, Dritan Cirami, Calogero Lino Campi, Riccardo Mari, Andrea Ognibene, Agostino Lorubbio, Maria Fanelli, Alessandra Romagnoli, Stefano Romagnani, Paola Minervini, Andrea Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy |
title | Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy |
title_full | Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy |
title_fullStr | Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy |
title_full_unstemmed | Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy |
title_short | Novel Biomarkers for Early Detection of Acute Kidney Injury and Prediction of Long-Term Kidney Function Decline after Partial Nephrectomy |
title_sort | novel biomarkers for early detection of acute kidney injury and prediction of long-term kidney function decline after partial nephrectomy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135876/ https://www.ncbi.nlm.nih.gov/pubmed/37189664 http://dx.doi.org/10.3390/biomedicines11041046 |
work_keys_str_mv | AT allinovimarco novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT sessafrancesco novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT villagianluca novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT cocciandrea novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT innocentisamantha novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT zanazzimaria novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT tofanilorenzo novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT paparellalaura novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT curidritan novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT ciramicalogerolino novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT campiriccardo novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT mariandrea novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT ognibeneagostino novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT lorubbiomaria novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT fanellialessandra novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT romagnolistefano novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT romagnanipaola novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy AT minerviniandrea novelbiomarkersforearlydetectionofacutekidneyinjuryandpredictionoflongtermkidneyfunctiondeclineafterpartialnephrectomy |