Role of Kidney Proximal Tubular Secretion in Critical Illness

肾近端肾小管分泌在危重疾病中的作用

• 批准号: 10620671
• 负责人: BRYAN R KESTENBAUM
• 金额: $ 67.13万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10620671
• 关键词: Acute; Acute Renal Failure with Renal Papillary Necrosis; Adult; Affect; Antibiotics; Apical; Binding Proteins; Biological Assay; Biological Markers; Biology; Blood Pressure; Cardiac; Cells; Cessation of life; Chronic Kidney Failure; Clinical; Clinical assessments; Cognitive; Coma; Complication; Creatinine; Critical Care; Critical Illness; Delirium; Dialysis procedure; Disease; Disease Progression; Diuretics; Dose; Endothelium; Event; Excision; Filtration; Functional disorder; Glomerular Filtration Rate; Goals; Hospitalization; Hospitals; Hypoxemia; Impairment; Incidence; Injury; Injury to Kidney; Intensive Care Units; Ischemia; Kidney; Laboratories; Link; Measurement; Measures; Medicine; Methods; Modality; Molecular Weight; Nature; Nephrology; Observational Study; Organ; Outcome; Oxygen; Pathway interactions; Patients; Persons; Pharmaceutical Preparations; Pharmacology; Plasma; Predisposition; Prognosis; Prospective cohort; Proximal Kidney Tubules; Renal function; Reperfusion Therapy; Risk; Risk Factors; Role; Serum; Severities; Staging; Testing; Toxin; Tubular formation; Uncertainty; Urea; Uremia; Urine; Vasoconstrictor Agents; Work; dosage; endothelial dysfunction; glomerular filtration; high risk; kidney dysfunction; mitochondrial dysfunction; mortality; nephrotoxicity; novel; research clinical testing; risk sharing; sedative; solute

Project Abstract Acute kidney injury (AKI) is one of the most common types of organ dysfunction among persons in the intensive care unit (ICU). Most causes of AKI involve injury to the proximal tubules of the kidneys. However, clinical evaluation of AKI relies on measurements of serum creatinine as a marker of glomerular filtration. Consequently, the severity and clinical implications of AKI may be misaligned with the biology of the disease. Proximal tubular secretory clearance is rarely measured due to a lack of reliable methods and uncertainty regarding clinical interpretation. We developed a novel targeted mass spectrometric assay to estimate tubular secretory clearance based on quantification of endogenous secretory solutes in plasma and urine, and we demonstrated that tubular secretory clearance is associated with the progression of chronic kidney disease and mortality independent of the estimated glomerular filtration rate. The general goal of this application is to advance clinical assessment of AKI by adding functional measurements that align with the underlying mechanisms of disease. We propose to measure tubular secretory clearances in a prospective cohort of critically ill adults who are at high risk for developing AKI. We will assess potential shared and unique risk factors for decline in tubular secretion and glomerular filtration, determine whether tubular secretory clearance adds to the prediction of measured drug levels, and test whether lower secretory clearance is associated with ICU delirium, coma and the severity and prognosis of AKI. 1

项目摘要

项目成果

Kidney Outcomes and Trajectories of Tubular Injury and Function in Critically Ill Persons with and without Coronavirus-2019.

感染和未感染 2019 冠状病毒的危重患者的肾脏结果以及肾小管损伤和功能的轨迹。

• DOI: 10.21203/rs.3.rs-3974635/v1
• 发表时间: 2024
• 期刊: Research square
• 作者: Granda,MichaelL;Tian,Frances;Zelnick,LeilaR;Bhatraju,PavanK;Wurfel,MarkM;Hoofnagle,Andrew;Morrell,Eric;Kestenbaum,Bryan
• 通讯作者: Kestenbaum,Bryan