PTM has received research support and honoraria for scientific advisory board activity and speaking engagements from Abbott Laboratories; and research support and honoraria for scientific advisory board activity from Alere Medical. PTM is also a consultant/scientific advisory board member for FAST Diagnostics and Argutus Medical.
Acute kidney injury (AKI) is a syndrome that is associated with a major burden of morbidity and mortality in a variety of high risk patient populations, many of them cared for by intensivists. Following renal transplantation, delayed graft function (DGF) caused by severe acute tubular necrosis (ATN), defined by a requirement for dialysis during the initial post-transplant week, complicates postoperative management, and if prolonged (>14 days), adversely affects allograft survival. Neutrophil gelatinase-associated lipocalin (NGAL) and other novel biomarkers can detect AKI earlier than serum creatinine, and can predict AKI severity in high risk patient populations, including kidney transplant recipients. Hollmen and colleagues now demonstrate that elevated urine NGAL in deceased kidney donors is a significant risk factor for prolonged post-transplant DGF in recipients. These findings have clear implications with regard to potentially improved assessment of deceased donor suitability for potential renal allograft donation. These findings are also consistent with the growing evidence that severe ATN diagnosed by markedly elevated levels of AKI biomarkers is a useful predictor of the requirement for acute renal replacement therapy in AKI patients.
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A, NGAL Meta-analysis Investigator Group: Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009, 54: 1012-1024. 10.1053/j.ajkd.2009.07.020. PubMedCrossRef
Koyner JL, Vaidya VS, Bennett MR, Ma Q, Worcester E, Akhter S, Raman S, Jeevanandam J, O'Connor MF, Devarajan P, Bonventre JV, Murray PT: Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury. Clin J Am Soc Nephrol. 2010, 5: 2154-2165. 10.2215/CJN.00740110. PubMedPubMedCentralCrossRef
Singer E, Elger A, Elitok S, Kettritz R, Nickolas TL, Barasch J, Luft FC, Schmidt-Ott KM: Urinary neutrophil gelatinase-associated lipocalin distinguishes pre-renal from intrinsic renal failure and predicts outcomes. Kidney Int. 2011,
Lebkowska U, Malyszko J, Lebkowska A, Koc-Zorawska E, Lebkowski W, Malyszko JS, Kowalewski R, Gacko M: Neutrophil gelatinase-associated lipocalin and cystatin C could predict renal outcome in patients undergoing kidney allograft transplantation: a prospective study. Transplant Proc. 2009, 41: 154-157. 10.1016/j.transproceed.2008.10.092. PubMedCrossRef
Kusaka M, Kuroyanagi Y, Mori T, Nagaoka K, Sasaki H, Maruyama T, Hayakawa K, Shiroki R, Kurahashi H, Hoshinaga K: Serum neutrophil gelatinase-associated lipocalin as a predictor of organ recovery from delayed graft function after kidney transplantation from donors after cardiac death. Cell Transplant. 2008, 17: 129-134. 10.3727/000000008783907116. PubMedCrossRef
- Diagnosis of kidney damage using novel acute kidney injury biomarkers: assessment of kidney function alone is insufficient
Patrick T Murray
- BioMed Central
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
Mail Icon II