Thursday, March 9, 2017

Renal biomarkers

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Deng Y et al. Critical Care 2017;21:46 - DOI: 10.1186/s13054-017-1626-0
"Although serum cystatin C (sCysC), urinary N-acetyl-β-d-glucosaminidase (uNAG), and urinary albumin/creatinine ratio (uACR) are clinically available, their optimal combination for acute kidney injury (AKI) detection and prognosis prediction remains unclear. We aimed to assess the discriminative abilities of these biomarkers and their possible combinations for AKI detection and intensive care unit (ICU) mortality prediction in critically ill adults...
The present study shows that the combination of a functional marker (sCysC) and a tubular damage marker (uNAG) at ICU admission had significantly better discriminative performance for AKI detection than either the individual biomarkers or the other two panels, and that combining this panel with a clinical model added significant value for AKI detection. Moreover, this panel also significantly contributed to the accuracy of the clinical model for ICU mortality prediction. This study was conducted in general adult ICUs with a heterogeneous cohort. Thus, our findings could have significant clinical implications for actual heterogeneous ICU patients at risk for AKI."