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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...

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Autores principales: 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
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
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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.
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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
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