A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury
Sepsis is a leading cause of morbidity and mortality in critically ill children, and acute kidney injury (AKI) is a frequent complication that confers an increased risk for poor outcomes. Despite the documented consequences of sepsis-associated AKI (SA-AKI), no effective disease-modifying therapies...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.632248/full |
| _version_ | 1818878733960871936 |
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| author | James D. Odum Hector R. Wong Hector R. Wong Natalja L. Stanski Natalja L. Stanski |
| author_facet | James D. Odum Hector R. Wong Hector R. Wong Natalja L. Stanski Natalja L. Stanski |
| author_sort | James D. Odum |
| collection | DOAJ |
| description | Sepsis is a leading cause of morbidity and mortality in critically ill children, and acute kidney injury (AKI) is a frequent complication that confers an increased risk for poor outcomes. Despite the documented consequences of sepsis-associated AKI (SA-AKI), no effective disease-modifying therapies have been identified to date. As such, the only treatment options for these patients remain prevention and supportive care, both of which rely on the ability to promptly and accurately identify at risk and affected individuals. To achieve these goals, a variety of biomarkers have been investigated to help augment our currently limited predictive and diagnostic strategies for SA-AKI, however, these have had variable success in pediatric sepsis. In this mini-review, we will briefly outline the current use of biomarkers for SA-AKI, and propose a new framework for biomarker discovery and utilization that considers the individual patient's sepsis inflammatory response. Now recognized to be a key driver in the complex pathophysiology of SA-AKI, understanding the dysregulated host immune response to sepsis is a growing area of research that can and should be leveraged to improve the prediction and diagnosis of SA-AKI, while also potentially identifying novel therapeutic targets. Reframing SA-AKI in this manner – as a direct consequence of the individual patient's sepsis inflammatory response – will facilitate a precision medicine approach to its management, something that is required to move the care of this consequential disorder forward. |
| first_indexed | 2024-12-19T14:18:53Z |
| format | Article |
| id | doaj.art-12913f0175ef40989f258c04b28a502e |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-19T14:18:53Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-12913f0175ef40989f258c04b28a502e2022-12-21T20:17:52ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-04-01910.3389/fped.2021.632248632248A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney InjuryJames D. Odum0Hector R. Wong1Hector R. Wong2Natalja L. Stanski3Natalja L. Stanski4Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United StatesDivision of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United StatesDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United StatesDivision of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United StatesDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United StatesSepsis is a leading cause of morbidity and mortality in critically ill children, and acute kidney injury (AKI) is a frequent complication that confers an increased risk for poor outcomes. Despite the documented consequences of sepsis-associated AKI (SA-AKI), no effective disease-modifying therapies have been identified to date. As such, the only treatment options for these patients remain prevention and supportive care, both of which rely on the ability to promptly and accurately identify at risk and affected individuals. To achieve these goals, a variety of biomarkers have been investigated to help augment our currently limited predictive and diagnostic strategies for SA-AKI, however, these have had variable success in pediatric sepsis. In this mini-review, we will briefly outline the current use of biomarkers for SA-AKI, and propose a new framework for biomarker discovery and utilization that considers the individual patient's sepsis inflammatory response. Now recognized to be a key driver in the complex pathophysiology of SA-AKI, understanding the dysregulated host immune response to sepsis is a growing area of research that can and should be leveraged to improve the prediction and diagnosis of SA-AKI, while also potentially identifying novel therapeutic targets. Reframing SA-AKI in this manner – as a direct consequence of the individual patient's sepsis inflammatory response – will facilitate a precision medicine approach to its management, something that is required to move the care of this consequential disorder forward.https://www.frontiersin.org/articles/10.3389/fped.2021.632248/fullsepsisacute kidney injurybiomarkersprecision medicineenrichment |
| spellingShingle | James D. Odum Hector R. Wong Hector R. Wong Natalja L. Stanski Natalja L. Stanski A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury Frontiers in Pediatrics sepsis acute kidney injury biomarkers precision medicine enrichment |
| title | A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury |
| title_full | A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury |
| title_fullStr | A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury |
| title_full_unstemmed | A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury |
| title_short | A Precision Medicine Approach to Biomarker Utilization in Pediatric Sepsis-Associated Acute Kidney Injury |
| title_sort | precision medicine approach to biomarker utilization in pediatric sepsis associated acute kidney injury |
| topic | sepsis acute kidney injury biomarkers precision medicine enrichment |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.632248/full |
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