AI Article Synopsis
- - The study explored using plasma suPAR and NGAL for early detection of acute kidney injury (AKI) in older patients, as traditional measures based on creatinine levels often lag behind actual kidney function changes.
- - Among 339 older patients analyzed, 9.7% developed AKI, with suPAR and NGAL showing a discriminatory power of 0.69 and 0.78, respectively, and a combination of both significantly improving detection to 0.80.
- - The study highlighted that 60.6% of patients with AKI were prescribed medications that should be avoided, emphasizing the importance of early detection in adjusting treatment recommendations for safer medication use.
Article Abstract
Diagnosis of acute kidney injury (AKI) based on plasma creatinine often lags behind actual changes in renal function. Here, we investigated early detection of AKI using the plasma soluble urokinase plasminogen activator receptor (suPAR) and neutrophil gelatinase-sssociated lipocalin (NGAL) and observed the impact of early detection on prescribing recommendations for renally-eliminated medications. This study is a secondary analysis of data from the DISABLMENT cohort on acutely admitted older (≥65 years) medical patients ( = 339). Presence of AKI according to kidney disease: improving global outcomes (KDIGO) criteria was identified from inclusion to 48 h after inclusion. Discriminatory power of suPAR and NGAL was determined by receiver-operating characteristic (ROC). Selected medications that are contraindicated in AKI were identified in Renbase. A total of 33 (9.7%) patients developed AKI. Discriminatory power for suPAR and NGAL was 0.69 and 0.78, respectively, at a cutoff of 4.26 ng/mL and 139.5 ng/mL, respectively. The interaction of suPAR and NGAL yielded a discriminatory power of 0.80, which was significantly higher than for suPAR alone ( = 0.0059). Among patients with AKI, 22 (60.6%) used at least one medication that should be avoided in AKI. Overall, suPAR and NGAL levels were independently associated with incident AKI and their combination yielded excellent discriminatory power for risk determination of AKI.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471084 | PMC |
| http://dx.doi.org/10.3390/ph14090843 | DOI Listing |
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