Proenkephalin for the Early Detection of Acute Kidney Injury in Hospitalized Patients with Chronic Kidney Disease.

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Proenkephalin for the Early Detection of Acute Kidney Injury in Hospitalized Patients with Chronic Kidney Disease.

Eur J Clin Invest. 2018 Jul 16;:e12999

Authors: Breidthardt T, Jaeger C, Christ A, Klima T, Mosimann T, Twerenbold R, Boeddinghaus J, Nestelberger T, Badertscher P, Struck J, Bergmann A, Hartmann O, Kalbermatter S, Marenzi G, Mueller C

Abstract
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: 111 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 (198pmol/l vs. 121pmol/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 (53pmol/l vs. 1pmol/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. This article is protected by copyright. All rights reserved.

PMID: 30009473 [PubMed - as supplied by publisher]

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