We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Sekisui Diagnostics

For 40 years SEKISUI Diagnostics has been committed to providing innovative medical diagnostics to physicians and lab... read more Featured Products: More products

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Urinary Biomarkers Predict Weaning From Acute Dialysis Therapy

By LabMedica International staff writers
Posted on 29 Nov 2022
Print article
Image: ELISA kit for liver-type fatty acid–binding protein (L-FABP). The level of L-FABP present in urine reflects the level of renal tubular dysfunction (Photo courtesy of Sekisui Medical Co)
Image: ELISA kit for liver-type fatty acid–binding protein (L-FABP). The level of L-FABP present in urine reflects the level of renal tubular dysfunction (Photo courtesy of Sekisui Medical Co)

Acute kidney injury is associated with a higher risk of chronic kidney disease (CKD), end-stage renal disease, and long-term adverse cardiovascular effects. Critically ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have a poor prognosis.

Several urinary biomarkers that can predict the development of AKI have been identified, including proximal renal tubular damage markers (e.g., liver-type fatty acid–binding protein [L-FABP], hemojuvelin [HJV], and kidney injury molecule 1 [KIM-1]), distal renal tubular damage markers (e.g., neutrophil gelatinase-associated lipocalin [NGAL] ), and inflammation markers (e.g., C-C motif chemokine ligand 14 [CCL14] and interleukin 18 [IL-18].

Nephrologists at the National Taiwan University Hospital (Taipei, Taiwan) and their colleagues prospectively recorded and analyzed clinical variables at several time points: (1) before starting renal replacement therapy (RRT), (2) at the time of weaning off RRT, and (3) 24 hours after stopping RRT. A total of 140 critically ill patients who received RRT at a multicenter referral hospital from August 2016 to January 2019 were enrolled.

At the time of stopping RRT, urine samples were collected and stored at −80 °C until analysis. The urine concentrations of novel AKI biomarkers were determined using enzyme-linked immunosorbent assay kits: renal L-FABP, (Sekisui Medical Co, Ltd, Tokyo, Japan); KIM-1, NGAL, CCL14 and IL-18, (R&D Systems, Minneapolis, MN, USA), HJV, (Cloud-Clone Corp, Katy, TX, USA).

The investigators reported that the 90-day mortality rate was 13.6% (19/140), and 47.9% (67/140) of the patients were successfully weaned from RRT. Cluster analysis showed that the following biomarkers were correlated with estimated glomerular filtration rate at the time of weaning off RRT: urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule 1, hemojuvelin, C-C motif chemokine ligand 14, interleukin 18, and liver-type fatty acid–binding protein (L-FABP). Among these, urinary L-FABP/creatinine (uL-FABP/Cr) at the time of weaning off RRT showed the best predictive performance for mortality (area under the receiver operating characteristic curve = 0.79).

The authors concluded that nearly half of the critically ill AKI-RRT patients in this study were successfully weaned from acute RRT. They demonstrated that uL-FABP/Cr level at the time of weaning from RRT independently predicted being dialysis free for more than 90 days and all-cause mortality. They also showed that a cutoff value of uL-FABP/Cr (log) level ≤ 2.2 μg/g Cr may be useful for clinical decision-making for AKI-RRT patients who attempt to wean off RRT. uL-FABP/Cr can be combined with SOFA score at the time of weaning off RRT to predict being dialysis free and 90-day mortality. The study was published in the November, 2022 issue of the journal Archives of Pathology & Laboratory Medicine.

Related Links:
National Taiwan University Hospital
Sekisui Medical Co, Ltd
R&D Systems
Cloud-Clone Corp

Gold Supplier
HDL Subfractions Kit
Lipoprint HDL Subfractions Kit
Automated Chemistry Analyzer
TC-Matrix 600
Incubation & Imaging System
BD KiestraReadA

Print article



view channel
Image: The Atellica HEMA 570 and 580 hematology analyzers remove workflow barriers (Photo courtesy of Siemens)

Next-Gen Hematology Analyzers Eliminate Workflow Roadblocks and Achieve Fast Throughput

Hematology testing is a critical aspect of patient care, utilized to establish a patient's health baseline, track treatment progress, or guide timely modifications to care. However, increasing constraints... Read more


view channel
Image: Newly observed anti-FSP antibodies have also been found to predict immune-related adverse events (Photo courtesy of Calviri)

First Blood-Based Biomarkers Test to Predict Treatment Response in Cancer Patients

Every year worldwide, lung cancer afflicts over two million individuals and almost the same number of people succumb to the disease. This malignancy leads the charts in cancer-related mortalities, with... Read more


view channel
Image: The rapid MTB strip test for tuberculosis can identify TB patients within two hours (Photo courtesy of Chulalongkorn University)

Rapid MTB Strip Test Detects Tuberculosis in Less Than an Hour without Special Tools

Tuberculosis (TB), a highly infectious disease, continues to pose significant challenges to public health worldwide. TB is caused by a bacterium known as "Mycobacterium tuberculosis," spreading through... Read more


view channel
Image: The UNIQO 160 (CE-IVDR) advances diagnostic analysis for autoimmune diseases (Photo courtesy of EUROIMMUN)

Novel Automated IIFT System Enables Cutting-Edge Diagnostic Analysis

A newly-launched automated indirect immunofluorescence test (IIFT) system for autoimmune disease diagnostics offers an all-in-one solution to enhance the efficiency of the complete IIFT process, comprising... Read more


view channel
Electronic biosensor uses DNA aptamers for detecting biomarkers in whole blood samples (Photo courtesy of Freepik)

Electronic Biosensor Detects Biomarkers in Whole Blood Samples without Addition of Reagents

The absence of robust, reliable, and user-friendly bioanalytical tools for early and timely diagnosis of cardiovascular diseases, particularly sudden cardiac arrest, leads to preventable deaths and imposes... Read more


view channel
Image: The global HbA1c testing devices market is expected to reach USD 2.56 billion in 2027 (Photo courtesy of Freepik)

Global Hemoglobin A1c Testing Devices Market Driven by Rising Prevalence of Diabetes

Hemoglobin A1c (HbA1c), or glycated hemoglobin, refers to hemoglobin with glucose attached. HbA1c testing devices are used for blood tests that determine average blood glucose, or blood sugar levels.... Read more
Copyright © 2000-2023 Globetech Media. All rights reserved.