Proenkephalin for the early detection of acute kidney injury in hospitalized patients with chronic kidney disease
Background The early detection of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) is an unmet clinical need. Proenkephalin (PENK) might improve the early detection of AKI. Methods One hundred and eleven hospitalized CKD patients undergoing radiographic contrast procedures wer...
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| Veröffentlicht in: | European journal of clinical investigation 2018-10, Vol.48 (10), p.e12999-n/a |
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| creator | Breidthardt, Tobias Jaeger, Cedric Christ, Andreas Klima, Theresia Mosimann, Tamina Twerenbold, Raphael Boeddinghaus, Jasper Nestelberger, Thomas Badertscher, Patrick Struck, Joachim Bergmann, Andreas Hartmann, Oliver Kalbermatter, Stefan Marenzi, Giancarlo Mueller, Christian |
| description | Background
The early detection of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) is an unmet clinical need. Proenkephalin (PENK) might improve the early detection of AKI.
Methods
One hundred and eleven hospitalized CKD patients undergoing radiographic contrast procedures were enrolled. PENK was measured in a blinded fashion at baseline (before contrast media administration) and on day 1 (after contrast media administration). The potential of PENK levels to predict contrast‐induced AKI was the primary endpoint.
Results
Baseline creatinine and baseline PENK were similar in AKI and no‐AKI patients. In AKI patients, day 1 PENK (198 pmol/L vs 121 pmol/L, P |
| doi_str_mv | 10.1111/eci.12999 |
| format | Article |
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The early detection of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) is an unmet clinical need. Proenkephalin (PENK) might improve the early detection of AKI.
Methods
One hundred and eleven hospitalized CKD patients undergoing radiographic contrast procedures were enrolled. PENK was measured in a blinded fashion at baseline (before contrast media administration) and on day 1 (after contrast media administration). The potential of PENK levels to predict contrast‐induced AKI was the primary endpoint.
Results
Baseline creatinine and baseline PENK were similar in AKI and no‐AKI patients. In AKI patients, day 1 PENK (198 pmol/L vs 121 pmol/L, P < 0.01) was significantly higher compared to no‐AKI patients. The area under the curve (AUC) for the prediction of AKI by day 1 PENK was 0.79, 95% CI: 0.70‐0.87, similar to serum creatinine: 0.78, 95% CI: 0.61‐0.95. Delta PENK was significantly higher in AKI compared to no‐AKI patients (53 pmol/L vs 1 pmol/L, P < 0.01). The AUC for the prediction of AKI by delta PENK was high (0.92, 95%CI 0.82‐1.00) and remained high for creatinine‐blind AKI (0.94, 95% CI: 0.87‐0.97).
Conclusion
Delta PENK levels improve the early detection of contrast‐induced AKI in CKD patients over serial creatinine sampling. Delta PENK accelerates the detection of creatinine‐blind AKI by 24 hours.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.12999</identifier><identifier>PMID: 30009473</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>acute kidney injury ; Acute Kidney Injury - chemically induced ; Acute Kidney Injury - diagnosis ; Aged ; Aged, 80 and over ; Area Under Curve ; Biomarkers - metabolism ; chronic kidney disease ; Contrast agents ; Contrast media ; Contrast Media - adverse effects ; Creatinine ; Creatinine - metabolism ; early detection ; Early Diagnosis ; Enkephalins - metabolism ; Female ; Hospitalization ; Humans ; Isotonic Solutions - administration & dosage ; Kidney diseases ; Kidneys ; Male ; Patients ; Proenkephalin ; Prospective Studies ; Protein Precursors - metabolism ; Renal Insufficiency, Chronic - complications ; sensitivity ; Sodium Bicarbonate - administration & dosage ; Sodium Chloride - administration & dosage ; specificity</subject><ispartof>European journal of clinical investigation, 2018-10, Vol.48 (10), p.e12999-n/a</ispartof><rights>2018 Stichting European Society for Clinical Investigation Journal Foundation</rights><rights>2018 Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>Copyright © 2018 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4149-46dd98936f4160dabc4ccba73371ab3aa5e05100c4e2d0e47b760f93495b10cf3</citedby><cites>FETCH-LOGICAL-c4149-46dd98936f4160dabc4ccba73371ab3aa5e05100c4e2d0e47b760f93495b10cf3</cites><orcidid>0000-0003-2671-6456</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Feci.12999$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Feci.12999$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30009473$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Breidthardt, Tobias</creatorcontrib><creatorcontrib>Jaeger, Cedric</creatorcontrib><creatorcontrib>Christ, Andreas</creatorcontrib><creatorcontrib>Klima, Theresia</creatorcontrib><creatorcontrib>Mosimann, Tamina</creatorcontrib><creatorcontrib>Twerenbold, Raphael</creatorcontrib><creatorcontrib>Boeddinghaus, Jasper</creatorcontrib><creatorcontrib>Nestelberger, Thomas</creatorcontrib><creatorcontrib>Badertscher, Patrick</creatorcontrib><creatorcontrib>Struck, Joachim</creatorcontrib><creatorcontrib>Bergmann, Andreas</creatorcontrib><creatorcontrib>Hartmann, Oliver</creatorcontrib><creatorcontrib>Kalbermatter, Stefan</creatorcontrib><creatorcontrib>Marenzi, Giancarlo</creatorcontrib><creatorcontrib>Mueller, Christian</creatorcontrib><title>Proenkephalin for the early detection of acute kidney injury in hospitalized patients with chronic kidney disease</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background
The early detection of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) is an unmet clinical need. Proenkephalin (PENK) might improve the early detection of AKI.
Methods
One hundred and eleven hospitalized CKD patients undergoing radiographic contrast procedures were enrolled. PENK was measured in a blinded fashion at baseline (before contrast media administration) and on day 1 (after contrast media administration). The potential of PENK levels to predict contrast‐induced AKI was the primary endpoint.
Results
Baseline creatinine and baseline PENK were similar in AKI and no‐AKI patients. In AKI patients, day 1 PENK (198 pmol/L vs 121 pmol/L, P < 0.01) was significantly higher compared to no‐AKI patients. The area under the curve (AUC) for the prediction of AKI by day 1 PENK was 0.79, 95% CI: 0.70‐0.87, similar to serum creatinine: 0.78, 95% CI: 0.61‐0.95. Delta PENK was significantly higher in AKI compared to no‐AKI patients (53 pmol/L vs 1 pmol/L, P < 0.01). The AUC for the prediction of AKI by delta PENK was high (0.92, 95%CI 0.82‐1.00) and remained high for creatinine‐blind AKI (0.94, 95% CI: 0.87‐0.97).
Conclusion
Delta PENK levels improve the early detection of contrast‐induced AKI in CKD patients over serial creatinine sampling. Delta PENK accelerates the detection of creatinine‐blind AKI by 24 hours.</description><subject>acute kidney injury</subject><subject>Acute Kidney Injury - chemically induced</subject><subject>Acute Kidney Injury - diagnosis</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Area Under Curve</subject><subject>Biomarkers - metabolism</subject><subject>chronic kidney disease</subject><subject>Contrast agents</subject><subject>Contrast media</subject><subject>Contrast Media - adverse effects</subject><subject>Creatinine</subject><subject>Creatinine - metabolism</subject><subject>early detection</subject><subject>Early Diagnosis</subject><subject>Enkephalins - metabolism</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Isotonic Solutions - administration & dosage</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Male</subject><subject>Patients</subject><subject>Proenkephalin</subject><subject>Prospective Studies</subject><subject>Protein Precursors - metabolism</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>sensitivity</subject><subject>Sodium Bicarbonate - administration & dosage</subject><subject>Sodium Chloride - administration & dosage</subject><subject>specificity</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kT9PHDEQxa0oKFwgRb5AZCkNKRb879bnMjpBgoSUFKG2vPas1seevdhenY5Pj-GAAinTvCl-82Y0D6GvlJzTWhdg_TllSqkPaEF5u2wYb9lHtCCEioYpyY7R55w3hJAV5ewTOua1VULyBbr_myKEO5gGM_qA-5hwGQCDSeMeOyhgi48Bxx4bOxfAd94F2GMfNnN6EjzEPPlShx_A4ckUD6FkvPNlwHZIMXj7OuN8BpPhFB31Zszw5UVP0O3V5b_17-bmz6_r9c-bxgoqVCNa59RK8bYXtCXOdFZY2xnJuaSm48YsgSwpIVYAcwSE7GRLesWFWnaU2J6foLOD75Ti_Qy56K3PFsbRBIhz1oxIsiJMClXR7-_QTZxTqNdpRmldyCXjlfpxoGyKOSfo9ZT81qS9pkQ_5aBrDvo5h8p-e3Gcuy24N_L18RW4OAA7P8L-_076cn19sHwEy6WShw</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Breidthardt, Tobias</creator><creator>Jaeger, Cedric</creator><creator>Christ, Andreas</creator><creator>Klima, Theresia</creator><creator>Mosimann, Tamina</creator><creator>Twerenbold, Raphael</creator><creator>Boeddinghaus, Jasper</creator><creator>Nestelberger, Thomas</creator><creator>Badertscher, Patrick</creator><creator>Struck, Joachim</creator><creator>Bergmann, Andreas</creator><creator>Hartmann, Oliver</creator><creator>Kalbermatter, Stefan</creator><creator>Marenzi, Giancarlo</creator><creator>Mueller, Christian</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2671-6456</orcidid></search><sort><creationdate>201810</creationdate><title>Proenkephalin for the early detection of acute kidney injury in hospitalized patients with chronic kidney disease</title><author>Breidthardt, Tobias ; 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The early detection of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) is an unmet clinical need. Proenkephalin (PENK) might improve the early detection of AKI.
Methods
One hundred and eleven hospitalized CKD patients undergoing radiographic contrast procedures were enrolled. PENK was measured in a blinded fashion at baseline (before contrast media administration) and on day 1 (after contrast media administration). The potential of PENK levels to predict contrast‐induced AKI was the primary endpoint.
Results
Baseline creatinine and baseline PENK were similar in AKI and no‐AKI patients. In AKI patients, day 1 PENK (198 pmol/L vs 121 pmol/L, P < 0.01) was significantly higher compared to no‐AKI patients. The area under the curve (AUC) for the prediction of AKI by day 1 PENK was 0.79, 95% CI: 0.70‐0.87, similar to serum creatinine: 0.78, 95% CI: 0.61‐0.95. Delta PENK was significantly higher in AKI compared to no‐AKI patients (53 pmol/L vs 1 pmol/L, P < 0.01). The AUC for the prediction of AKI by delta PENK was high (0.92, 95%CI 0.82‐1.00) and remained high for creatinine‐blind AKI (0.94, 95% CI: 0.87‐0.97).
Conclusion
Delta PENK levels improve the early detection of contrast‐induced AKI in CKD patients over serial creatinine sampling. Delta PENK accelerates the detection of creatinine‐blind AKI by 24 hours.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>30009473</pmid><doi>10.1111/eci.12999</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2671-6456</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | acute kidney injury Acute Kidney Injury - chemically induced Acute Kidney Injury - diagnosis Aged Aged, 80 and over Area Under Curve Biomarkers - metabolism chronic kidney disease Contrast agents Contrast media Contrast Media - adverse effects Creatinine Creatinine - metabolism early detection Early Diagnosis Enkephalins - metabolism Female Hospitalization Humans Isotonic Solutions - administration & dosage Kidney diseases Kidneys Male Patients Proenkephalin Prospective Studies Protein Precursors - metabolism Renal Insufficiency, Chronic - complications sensitivity Sodium Bicarbonate - administration & dosage Sodium Chloride - administration & dosage specificity |
| title | Proenkephalin for the early detection of acute kidney injury in hospitalized patients with chronic kidney disease |
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