Srisawat et al.(4545 Srisawat N, Murugan R, Lee M, Kong L, Carter M, Angus DC, Kellum JA; Genetic and Inflammatory Markers of Sepsis (GenIMS) Study Investigators. Plasma neutrophil gelatinase-associated lipocalin predicts recovery from acute kidney injury following community-acquired pneumonia. Kidney Int. 2011;80(5):545-52.)
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181 patients with community-acquired pneumonia and AKI RIFLE-F |
Plasma: NGAL and IL-6 |
First day of RIFLE F classification |
Alive and neither requiring renal replacement therapy during hospitalization nor having persistent RIFLE F classification at hospital discharge. |
pNGAL predicted failure to recover renal function. |
AUC of 0.71 (95% CI 0.61 - 0.81) |
A pNGAL level of 257ng/mL predicted failure to recover |
Sensitivity: 68%; specificity: 75%, with positive predictive value of 73% and negative predictive value of 70%. |
Srisawat et al.(4646 Srisawat N, Wen X, Lee M, Kong L, Elder M, Carter M, et al. Urinary biomarkers and renal recovery in critically ill patients with renal support. Clin J Am Soc Nephrol. 2011;6(8):1815-23.)
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76 critically ill patients who developed AKI and required renal replacement therapy |
Urine: NGAL, HGF, cystatin C, IL-18, NGAL/matrix metalloproteinase protein-9 and Creatinine |
Days 1, 7, and 14 from RRT initiation |
Survival and dialysis independence at 60 days. |
uHGF on day 14 predicts AKI recovery |
AUC 0.74 (95%CI 0.53 - 0.94) |
The fall of uHGF over the 14 days predicts AKI recovery |
AUC 0.74 (95%CI 0.60 - 0.89) |
uNGAL on day 14 predicts AKI recovery |
AUC 0.66 (95%CI 0.44 - 0.88) |
The fall of uNGAL over the 14 days predicts AKI recovery |
AUC 0.7 (95%CI 0.55 - 0.84) |
Moon et al.(4848 Moon SJ, Park HB, Yoon SY, Lee SC. Urinary biomarkers for early detection of recovery in patients with acute kidney injury. J Korean Med Sci. 2013;28(8):1181-6.)
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66 AKI patients with AKI |
Urine: NGAL and cystatin C |
Every 2 days during 8 days after AKI diagnosis |
50% or greater decrease in plasma creatinine from the peak level. |
uNGAL at day 0 was a useful predictor of renal recovery |
AUC = 0.78, 95%CI 0.65 - 0.9, p < 0.01 |
uNGAL level of 348.2ng/mL predicts AKI recovery. |
Sensitivity: 0.84, specificity: 0.687, AUC for predicting AKI recovery using uNGAL on days 2, 4, 6 and 8 were 0.813, 0.854, 0.884, and 0.969, respectively |
uNGAL was an earlier marker of recovery compared to plasma creatinine. |
Luk et al.(7777 Luk CC, Chow KM, Kwok JS, Kwan BC, Chan MH, Lai KB, et al. Urinary biomarkers for the prediction of reversibility in acute-on-chronic renal failure. Dis Markers. 2013;34(3):179-85.)
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39 patients with pre-existing CKD and AKI RIFLE-I or F |
Urine: NGAL, mRNA expression of kidney injury molecule-1, IL-18, α-1-M, sodium/hydrogen exchanger-3, beta-2 microglobulin and N-acetyl-β-D-glucosaminidase |
First 24 hours of hospital admission |
Evaluation at 6 months. Complete recovery: creatinine falling below 110% of the baseline. Partial recovery: creatinine remaining above 110% of the baseline and below 90% of the creatinine at presentation. No recovery: creatinine remaining above 90% of the creatinine at presentation, or whenever the patient became dialysis dependent. |
Urine α-1-M expression had a modest but statistically significant correlation with the degree of improvement in renal failure. |
r = 0.387, p = 0.026 |
Aregger et al.(8282 Aregger F, Uehlinger DE, Witowski J, Brunisholz RA, Hunziker P, Frey FJ, et al. Identification of IGFBP-7 by urinary proteomics as a novel prognostic marker in early acute kidney injury. Kidney Int. 2014;85(4):909-19.)
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12 critically ill patients |
Urine: α-1-M, α-1 antitrypsin, apolipoprotein D, calreticulin, cathepsin D, CD59, IGFBP-7 and NGAL |
First day of AKI |
Early AKI recovery: less than 7 days; late AKI recovery: more than 7 days. |
uIGFBP-7 and uNGAL best predicted renal recovery; uIGFBP-7 was a more accurate predictor of renal outcome than uNGAL. |
uIGFBP-7 AUC: 0.74; uNGAL AUC: 0.70). |
Meersch et al.(84) |
26 patients with AKI after cardiac surgery with cardiopulmonary bypass |
Urine: TIMP-2*IGFBP7 |
Preoperatively, 4 hours, 12 hours and 24 hours after coming off cardiopulmonary bypass |
Plasma creatinine value at hospital discharge superior or lower than that at baseline. |
uTIMP-2*IGFBP7 decline between 4 and 24 hours after surgery served as an accurate marker of renal recovery. |
AUC of 0.79 (95%CI: 0.65 - 0.92) |
uNGAL decline between 4 and 24 hours after surgery did not served as an accurate marker of renal recovery. |
AUC of 0.48 (95%CI: 0.31 - 0.64). |