Urinary Biomarkers for Acute Kidney Injury in Critical Illness

危重疾病中急性肾损伤的尿液生物标志物

• 批准号: 7275018
• 负责人: Steven G Coca
• 金额: $ 6.68万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7275018
• 关键词: Acute Kidney Failure; Acute Lung Injury; Acute Renal Failure with Renal Papillary Necrosis; Affect; American; Animals; Area; Attenuated; Biological Markers; Cessation of life; Characteristics; Chronic Kidney Failure; Clinical; Clinical Data; Coca; Complication; Creatinine; Critical Illness; Data Collection; Development; Diagnosis; Early Diagnosis; Elevation; End Point; Enrollment; Event; Failure; Future; Gelatinase A; Glomerular Filtration Rate; Goals; Health Personnel; Hospital Mortality; Human; Injury; Intensive Care Units; Interleukin-18; Intervention Trial; Kidney; Kidney Diseases; Kidney Failure; Multicenter Studies; Nephrology; Patients; Physiological; Pilot Projects; Prevention; Process; Proteins; Public Health; Rate; Receiver Operating Characteristics; Renal Replacement Therapy; Renal function; Research; Research Personnel; Risk; Risk Factors; Sample Size; Sampling; Sensitivity and Specificity; Sepsis; Serum; Societies; Stratification; Subgroup; Testing; Time; Troponin; Urine; Validation; acute coronary syndrome; base; day; drug development; improved; mortality; post gamma-globulins; prognostic; sample collection; tool; urinary

DESCRIPTION (provided by applicant): Acute kidney injury (AKI) is common in critically ill patients. Serum creatinine is a poor marker of renal function. The lack of progress in the prevention and treatment of AKI may be attributable to poor physiologic markers for early and reliable diagnosis of AKI in reseach studies. Urinary IL-18, neutrophil gelatinase- associated lipocalin (NGAL), and cystatin C are three promising biomarkers for the early detection and potential risk-stratification of AKI. The first aim of this pilot study is to evaluate urine IL-18, NGAL, and cystatin C as biomarkers for the the early detection of AKI in patients with sepsis and/or acute lung injury. The second aim is to determine if urinary IL-18, NGAL, and cystatin C concentrations can risk-statify patients with AKI in terms of the need for renal replacement therapy and in-hospital mortality. The results from this study will help later guide a definitive large multicenter study by developing the study processes and data collection; guiding duration of sample collection and overall sample size for event rates; identifying important subgroups of AKI amenable to study with biomarkers, and finally by developing a biomarker panel for the early and reliable diagnosis of AKI in the ICU setting that has incremental prognostic value. Relevance to public health: In 2006, our ability to diagnose abupt kidney failure is inaccurate and inefficient. Earlier recognition of abrupt kidney failure via newly discovered proteins in the urine will aid health care providers in making a prompt diagnosis, and may predict how severe the kidney failure will be. Furthermore, it will help researchers to perform efficient studies of drug development studies to improve kidney failure by enabling them to identify and enroll patients will kidney failure more rapidily.

描述（由申请人提供）：急性肾损伤（AKI）在危重患者中很常见。血清肌酐是肾功能的不良标志。 AKI 预防和治疗方面缺乏进展可能是由于研究中用于早期、可靠诊断 AKI 的生理标志物较差。尿液 IL-18、中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 和胱抑素 C 是用于 AKI 早期检测和潜在风险分层的三种有前景的生物标志物。该试点研究的首要目的是评估尿液 IL-18、NGAL 和胱抑素 C 作为脓毒症和/或急性肺损伤患者 AKI 早期检测的生物标志物。第二个目的是确定尿 IL-18、NGAL 和胱抑素 C 浓度是否可以根据肾脏替代治疗的需要和院内死亡率对 AKI 患者进行风险分层。这项研究的结果将有助于以后通过开发研究流程和数据收集来指导一项明确的大型多中心研究；指导样本收集的持续时间和事件发生率的总体样本量；确定适合使用生物标志物进行研究的 AKI 重要亚组，最后开发生物标志物组，以便在 ICU 环境中早期、可靠地诊断 AKI，从而提高预后价值。与公共卫生的相关性：2006 年，我们诊断突发性肾衰竭的能力不准确且效率低下。通过尿液中新发现的蛋白质及早识别突然肾衰竭将有助于医疗保健提供者做出及时诊断，并可以预测肾衰竭的严重程度。此外，它将帮助研究人员进行有效的药物开发研究，通过使他们能够更快地识别和招募患有肾衰竭的患者来改善肾衰竭。