1. Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.
- Author
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Koyner JL, Arndt C, Baldira Martinez de Irujo J, Coelho S, Garcia-Montesinos de la Peña M, di Girolamo L, Joannidis M, Jorge-Monjas P, Koch C, Lobaz S, Meyer A, Ostermann M, Pertica N, Prowle JR, Silversides J, Zarbock A, Echeverri J, Harenski K, and Forni LG
- Subjects
- Humans, Consensus, Chemokines, CC urine, Europe, Acute Kidney Injury urine, Acute Kidney Injury therapy, Acute Kidney Injury diagnosis, Biomarkers urine, Delphi Technique, Renal Replacement Therapy
- Abstract
Background: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions., Methods: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale)., Results: Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan ( p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences., Conclusion: Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.
- Published
- 2024
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