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05.09.2023 | Original

Subclinical and clinical acute kidney injury share similar urinary peptide signatures and prognosis

verfasst von: Louis Boutin, Agnieszka Latosinska, Harald Mischak, Benjamin Deniau, Ayu Asakage, Matthieu Legrand, Etienne Gayat, Alexandre Mebazaa, Christos E. Chadjichristos, François Depret

Erschienen in: Intensive Care Medicine | Ausgabe 10/2023

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Abstract

Purpose

Acute kidney injury (AKI) is a frequent and severe condition in intensive care units (ICUs). In 2020, the Acute Dialysis Quality Initiative (ADQI) group proposed a new stage of AKI, referred to as stage 1S, which represents subclinical disease (sAKI) defined as a positive biomarker but no increase in serum creatinine (sCr). This study aimed to determine and compare the urinary peptide signature of sAKI as defined by biomarkers.

Methods

This is an ancillary analysis of the prospective, observational, multinational FROG-ICU cohort study. AKI was defined according to the Kidney Disease Improving Global Outcome definition (AKI_KDIGO). sAKI was defined based on the levels of the following biomarkers, which exceeded the median value: neutrophil gelatinase-associated lipocalin (pNGAL, uNGAL), cystatin C (pCysC, uCysC), proenkephalin A 119–159 (pPENKID) and liver fatty acid binding protein (uLFABP). Urinary peptidomics analysis was performed using capillary electrophoresis-mass spectrometry. Samples were collected at the time of study inclusion.

Results

One thousand eight hundred eighty-five patients had all biomarkers measured at inclusion, which included 1154 patients without AKI (non-AKI_KDIGO subgroup). The non-AKI_KDIGO subgroup consisted of individuals at a median age of 60 years [48, 71], among whom 321 (27.8%) died. The urinary peptide signatures of sAKI, regardless of the biomarkers used for its definition, were similar to the urinary peptide signatures of AKI_KDIGO (inflammation, haemolysis, and endothelial dysfunction). These signatures were also associated with 1-year mortality.

Conclusion

Biomarker-defined sAKI is a common and severe condition observed in patients within intensive care units with a urinary peptide signature that is similar to that of AKI, along with a comparable prognosis.

Graphical abstract

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Titel: Subclinical and clinical acute kidney injury share similar urinary peptide signatures and prognosis
verfasst von: Louis Boutin
Agnieszka Latosinska
Harald Mischak
Benjamin Deniau
Ayu Asakage
Matthieu Legrand
Etienne Gayat
Alexandre Mebazaa
Christos E. Chadjichristos
François Depret
Publikationsdatum: 05.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 10/2023
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-023-07198-2

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Subclinical and clinical acute kidney injury share similar urinary peptide signatures and prognosis