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Urinary excretion of twenty peptides forms an early and accurate diagnostic pattern of acute kidney injury
- Source :
- Kidney International; Vol 78
- Publication Year :
- 2010
- Publisher :
- Elsevier BV, 2010.
-
Abstract
- Early and accurate detection of acute kidney injury (AKI) is needed to prevent the progression to chronic kidney disease and to improve outcome. Here we used capillary electrophoresis-mass spectrometry to identify urinary peptides predictive of AKI in a training set of 87 urine samples longitudinally collected from patients in an intensive care unit. Within this patient cohort, 16 developed AKI while 14 maintained normal renal function. The sequence of twenty peptides significantly associated with AKI was identified. They were found to be degradation products of six proteins. These formed a diagnostic pattern. Peptides of albumin, α-1-antitrypsin, and β-2-microglobulin were upregulated but fragments of fibrinogen α and collagens 1 α(I) and 1 α(III) were downregulated in AKI. After cross-validation of the training set, a good diagnostic performance of the marker pattern was found with an area under the ROC curve of 0.91. This was confirmed in a blinded validation set of 20 patients in the intensive care unit and 31 allogeneic hematopoietic stem cell transplantation patients, of which 13 had and 18 had not experienced an episode of AKI. In comparison to more established markers of AKI such as serum cystatin C and urinary kidney injury molecule-1, interleukin-18, and neutrophil gelatinase associated-lipocalin, the proteomic marker pattern was found to be of superior prognostic value, detecting AKI up to 5 days in advance of the rise in serum creatinine.
- Subjects :
- Male
Nephrology
Pathology
diagnosis
medicine.medical_treatment
Medizin
030232 urology & nephrology
Hematopoietic stem cell transplantation
urologic and male genital diseases
law.invention
Cohort Studies
chemistry.chemical_compound
0302 clinical medicine
law
Longitudinal Studies
Aged, 80 and over
0303 health sciences
Acute kidney injury
Middle Aged
Prognosis
Intensive care unit
female genital diseases and pregnancy complications
3. Good health
Intensive Care Units
acute kidney injury
Female
Adult
medicine.medical_specialty
Critical Illness
Urinary system
Urology
Sensitivity and Specificity
acute renal failure
Collagen Type I
03 medical and health sciences
proteomics
Albumins
Internal medicine
medicine
Humans
Aged
030304 developmental biology
Creatinine
business.industry
Albumin
Fibrinogen
medicine.disease
chemistry
alpha 1-Antitrypsin
Peptides
beta 2-Microglobulin
business
Biomarkers
Kidney disease
Subjects
Details
- ISSN :
- 00852538
- Volume :
- 78
- Database :
- OpenAIRE
- Journal :
- Kidney International
- Accession number :
- edsair.doi.dedup.....605d3ebfbcfaeee14b23ee09029ac269