WASHINGTON (Feb. 6, 2012) -- Two biomarkers used in combination can improve risk assessment of acute kidney injury (AKI), according to new research from an international multi-center study. AKI strikes up to seven percent of hospitalized patients and is associated with significant morbidity and mortality.
The results, published today in Critical Care, address one of the most costly and deadly conditions affecting critically ill hospitalized patients. The findings provide much needed insight into the most compelling biomarkers of acute kidney injury.
“If unchecked, AKI can lead to loss of kidney function in a patient, often resulting in lower quality of life or even death,” said Dr. John Kellum, a critical care physician at UPMC. “The data show that two urinary biomarkers of AKI can tell a doctor if a patient is at risk of kidney injury.”
The two-part study collected data on critically ill patients in North American and Europe.
In the first part of the study, led by Dr. Kianoush Kashani of Mayo Clinic, researchers performed an exhaustive evaluation of nearly 340 biomarkers to define the two best biomarkers with the highest correlation to risk of acute kidney injury.
In the second part of the study, led by Dr. Kellum and Dr. Lakhmir Chawla, anesthesiologist at The GW Medical Faculty Associates and associate professor of Anesthesiology & Critical Care medicine and of Medicine at The George Washington University School of Medicine & Health Sciences, researchers from 35 medical centers validated the effectiveness of the two novel biomarkers in 740 critically ill patients and compared their performance with other biomarkers, including serum creatinine.
- The two novel biomarkers validated were Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2), both inducers of G1 cell cycle arrest, a key mechanism implicated in AKI.
- Together IGFBP7 and TIMP-2 demonstrated an AUC of .80 (0.76 and 0.79, respectively).
- Together IGFBP7 and TIMP-2 were superior to all commonly used markers of AKI (p 0.72.
“The results are striking not only in terms of identifying new robust markers that have improved performance characteristics when directly compared with existing methods for assessing risk of AKI, but also in terms of bolstering understanding of the mechanism of this disease,” said Dr. Chawla.
AKI is a complex and increasingly prevalent condition associated with high mortality in critically ill patients. Although it occurs quickly (over the course of hours to days), there is commonly a challenge in risk assessment due to the inadequate tools currently available to physicians. Failure to recognize and manage AKI in the early stages can lead to devastating outcomes for patients and increased costs to the healthcare system.
Benefits of assessing risk of AKI could include earlier intervention to mitigate loss of kidney function, saved lives and reduced hospital and long-term healthcare costs as a result of avoiding progression to severe and permanent kidney damage.
The study was sponsored by Astute Medical, Inc.
