Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department
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 obser...
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MDPI AG
2021-08-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/14/9/843 |
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| author | Anne Byriel Walls Anne Kathrine Bengaard Esben Iversen Camilla Ngoc Nguyen Thomas Kallemose Helle Gybel Juul-Larsen Baker Nawfal Jawad Mads Hornum Ove Andersen Jesper Eugen-Olsen Morten Baltzer Houlind |
| author_facet | Anne Byriel Walls Anne Kathrine Bengaard Esben Iversen Camilla Ngoc Nguyen Thomas Kallemose Helle Gybel Juul-Larsen Baker Nawfal Jawad Mads Hornum Ove Andersen Jesper Eugen-Olsen Morten Baltzer Houlind |
| author_sort | Anne Byriel Walls |
| collection | DOAJ |
| description | 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 (<i>n</i> = 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<sup>®</sup>. 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 (<i>p</i> = 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. |
| first_indexed | 2024-03-10T07:19:35Z |
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| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-10T07:19:35Z |
| publishDate | 2021-08-01 |
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| series | Pharmaceuticals |
| spelling | doaj.art-be9cf32989da433a821e19bb3a24c7f82023-11-22T14:44:13ZengMDPI AGPharmaceuticals1424-82472021-08-0114984310.3390/ph14090843Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency DepartmentAnne Byriel Walls0Anne Kathrine Bengaard1Esben Iversen2Camilla Ngoc Nguyen3Thomas Kallemose4Helle Gybel Juul-Larsen5Baker Nawfal Jawad6Mads Hornum7Ove Andersen8Jesper Eugen-Olsen9Morten Baltzer Houlind10Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, DenmarkDepartment of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, DenmarkDepartment of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, 2650 Copenhagen, DenmarkDepartment of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, DenmarkDepartment of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, 2650 Copenhagen, DenmarkDepartment of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, 2650 Copenhagen, DenmarkDepartment of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, 2650 Copenhagen, DenmarkDepartment of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, DenmarkDepartment of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, 2650 Copenhagen, DenmarkDepartment of Clinical Research, Copenhagen University Hospital—Amager and Hvidovre, 2650 Copenhagen, DenmarkDepartment of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, DenmarkDiagnosis 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 (<i>n</i> = 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<sup>®</sup>. 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 (<i>p</i> = 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.https://www.mdpi.com/1424-8247/14/9/843acute kidney injuryearly biomarkerplasma neutrophil gelatinase-associated lipocalinsoluble urokinase plasminogen activator receptormedication optimizationolder patients |
| spellingShingle | Anne Byriel Walls Anne Kathrine Bengaard Esben Iversen Camilla Ngoc Nguyen Thomas Kallemose Helle Gybel Juul-Larsen Baker Nawfal Jawad Mads Hornum Ove Andersen Jesper Eugen-Olsen Morten Baltzer Houlind Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department Pharmaceuticals acute kidney injury early biomarker plasma neutrophil gelatinase-associated lipocalin soluble urokinase plasminogen activator receptor medication optimization older patients |
| title | Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department |
| title_full | Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department |
| title_fullStr | Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department |
| title_full_unstemmed | Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department |
| title_short | Utility of suPAR and NGAL for AKI Risk Stratification and Early Optimization of Renal Risk Medications among Older Patients in the Emergency Department |
| title_sort | utility of supar and ngal for aki risk stratification and early optimization of renal risk medications among older patients in the emergency department |
| topic | acute kidney injury early biomarker plasma neutrophil gelatinase-associated lipocalin soluble urokinase plasminogen activator receptor medication optimization older patients |
| url | https://www.mdpi.com/1424-8247/14/9/843 |
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