Featured Research

from universities, journals, and other organizations

Biomarkers identify acute kidney injury in emergency patients

Date:
January 9, 2012
Source:
Columbia University Medical Center
Summary:
Acute kidney injury has severe consequences, with a 25 to 80 percent risk of in-hospital death. Researchers have found a way to diagnose AKI using a urine test, enabling emergency departments to identify these high-risk patients when they first arrive at the hospital.

Acute kidney injury (AKI) has severe consequences, with a 25 to 80 percent risk of in-hospital death. Researchers have found a way to diagnose AKI using a urine test, enabling emergency departments to identify these high-risk patients when they first arrive at the hospital. The study will be published online on January 9, 2012, in the Journal of the American College of Cardiology.

Physicians typically measure a patient's creatinine levels to determine kidney function. But creatinine levels can remain normal for several hours after acute kidney damage, and an accurate assessment requires measurements taken over a period of 1-3 days. This limits their usefulness in an emergency room. Urinary biomarkers, however, require only a half hour or so to obtain a measure of the severity of kidney damage, explains Thomas Nickolas, MD, MS, assistant professor of clinical medicine at Columbia University College of Physicians and Surgeons and a kidney specialist at NewYork-Presbyterian Hospital/The Allen Hospital.

In an international, multi-center study, researchers from Columbia University Medical Center at NewYork-Presbyterian Hospital/The Allen Hospital; Staten Island University Hospital; and Charité-Universitätsmedizin, Max Delbruck Center for Molecular Medicine, and Helios Clinics, Berlin, Germany, took a single measure of five urinary biomarkers from 1,635 emergency room patients upon their admission to the hospital. Although all five biomarkers were elevated in cases of iAKI (intrinsic AKI, the most severe form of AKI), the biomarker called uNGAL was most accurate in the diagnosis of iAKI and best predicted its duration and severity. uNGAL, along with another biomarker, called Kim-1, most accurately predicted death or the need to start dialysis during hospitalization. uNGAL was discovered at NewYork-Presbyterian/Columbia University and at Cincinnati Children's Hospital; it was measured in this study by Abbott's ARCHITECT-NGAL assay, which is available commercially outside the US.

"The ability to identify acute kidney damage while the patient is in triage is especially important in busy urban hospitals, where patients cannot wait for repetitive measures of creatinine and are frequently lost to follow-up," said senior author Jonathan Barasch, MD, PhD, associate professor of medicine and of anatomy and cell biology at Columbia University College of Physicians and Surgeons and a kidney specialist at NewYork-Presbyterian Hospital/The Allen Hospital. "The use of urinary biomarkers could also be of great use to the military, at disaster sites, and in other situations where quick medical decisions must be made."

"Combining urinary biomarkers such as uNGAL with the current standard marker creatinine will significantly improve the identification of patients at risk of death or dialysis in the hospital," added Dr. Kai Schmidt-Ott, MD, a kidney specialist at Charité Berlin, research group leader at the Max Delbrück Center for Molecular Medicine, and adjunct assistant professor at Columbia University Medical Center. "Identifying these patients at the earliest possible time in the emergency room may enable us to introduce new treatment options to improve their outcomes."

The study's authors are Thomas L. Nickolas (CUMC/NYP), Kai M. Schmidt-Ott (Max Delbruck Center for Molecular Medicine) who contributed equally and Pietro Canetta (CUMC/NYP), Catherine Foster (CUMC), Eugenia Singer (Max Delbruck Center for Molecular Medicine), Meghan Sise (CUMC), Antje Elger (Max Delbruck Center for Molecular Medicine), Omar Maarouf (Staten Island University Hospital), David Antonio Sola-Del Valle (CUMC/NYP), Matthew O'Rourke (CUMC/NYP), Evan Sherman (CUMC/NYP), Peter Lee (CUMC), Abdallah Geara (CUMC/NYP), Philip Imus (CUMC/NYP), Achuta Guddati (CUMC), Allison Polland (CUMC), Wasiq Rahman (CUMC), Saban Elitok (Max Delbruck Center for Molecular Medicine), Nasir Malik (CUMC), James Giglio (CUMC/NYP), Suzanne El-Sayegh (Staten Island University Hospital), Prasad Devarajan (Cincinnati Children's Hospital), Sudarshan Hebbar (Abbott Laboratories), Subodh J. Saggi (Staten Island University Hospital), Barry Hahn (Staten Island University Hospital), Ralph Kettritz (Max Delbruck Center for Molecular Medicine), Friedrich C. Luft (Max Delbruck Center for Molecular Medicine), and Jonathan Barasch (CUMC/NYP).

The study was supported by the NIH (DK073462) and the Deutsche Forschungsgemeinschaft.


Story Source:

The above story is based on materials provided by Columbia University Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Columbia University Medical Center. "Biomarkers identify acute kidney injury in emergency patients." ScienceDaily. ScienceDaily, 9 January 2012. <www.sciencedaily.com/releases/2012/01/120109212013.htm>.
Columbia University Medical Center. (2012, January 9). Biomarkers identify acute kidney injury in emergency patients. ScienceDaily. Retrieved September 21, 2014 from www.sciencedaily.com/releases/2012/01/120109212013.htm
Columbia University Medical Center. "Biomarkers identify acute kidney injury in emergency patients." ScienceDaily. www.sciencedaily.com/releases/2012/01/120109212013.htm (accessed September 21, 2014).

Share This



More Health & Medicine News

Sunday, September 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) — Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com
Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) — Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) — A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) — The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins