Abstract: SA-PO085

Use of Biomarkers in the Early Diagnosis of AKI in Critically Ill Patients: Systematic Review

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Pedroso, Luana Amaral, Federal University of Minas Gerais, Ouro Preto, Brazil
  • Nobre, Vandack, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  • De almeida, Claudmeire Dias carneiro, UFMG, Belo Horizonte, Brazil
  • De, Nathalia Sernizon, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  • Souza, Rafael, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  • Simões e silva, Ana cristina, UFMG, Brazil, Belo Horizonte, Brazil
  • Martins, Maria auxiliadora Parreiras, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Background

Acute kidney injury (AKI) is a recognized condition among hospitalized patients and it is more common in intensive care units (ICU). AKI can be assessed by measuring serum creatinine; however, is considered a poor and delayed marker. New circulating and urinary biomarkers emerged in recent decades as promising in the early diagnosis of AKI, with better sensitivity (s) and specificity (sp) profile. Given its potential benefits in the diagnosis and prognosis of AKI, the need of using these new biomarkers in clinical practice is consensual. This study aims to perform a systematic review of literature, that evaluated the performance of biomarkers for the early diagnosis of AKI.

Methods

A systematic review of the medical literature, including experimental and observational studies published in MEDLINE, BVS, CINAHL and EMBASE, published between 2006-2016. The review will include experimental and observational studies, involving patients with 18 years or older more admitted to an ICU. The systematic review protocol was submitted and approved by the International Prospective Register of Systematic Reviews (PROSPERO), under the code CRD42016037325.

Results

Eight studies were selected. The main biomarkers investigated were neutrophil gelatinase-associated lipocalin (NGAL), L-type fatty acid binding protein (L-FABP), N-acetyl glucosamine (NAG) and cystatin C. In 16 out of 23 (66.7%) tests performed by the studies, analyzes have used urine samples. The biomarkers that presented the highest s and sp profile were the heat shock protein-72 (s=100%, sp=90%) and Interleukin 18 (s=92%, sp=100%). Cystatin C showed poor performance in two studies. Overall, two studies presented unfavorable results for the use of biomarker because their levels were significantly affected by comorbidities even in the absence of AKI.

Conclusion

All biomarkers have suffered some influence of other factors, such as comorbidities or etiology of AKI. An understanding of a single biomarker is unable to help identifying the etiology and mechanisms of AKI. Thus, the use of a diagnostic kit combining different biomarkers could be suggested for early diagnosis of AKI. Besides, the identification of AKI etiology may be helpful to guide the implementation strategies.