Utility of suPAR and NGAL for AKi risk stratification and early optimization of renal risk medications among older patients in the emergency department
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Utility of suPAR and NGAL for AKi risk stratification and early optimization of renal risk medications among older patients in the emergency department. / Walls, Anne Byriel; Bengaard, Anne Kathrine; Iversen, Esben; Nguyen, Camilla Ngoc; Kallemose, Thomas; Juul‐larsen, Helle Gybel; Jawad, Baker Nawfal; Hornum, Mads; Andersen, Ove; Eugen‐olsen, Jesper; Houlind, Morten Baltzer.
In: Pharmaceuticals, Vol. 14, No. 9, 843, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Utility of suPAR and NGAL for AKi risk stratification and early optimization of renal risk medications among older patients in the emergency department
AU - Walls, Anne Byriel
AU - Bengaard, Anne Kathrine
AU - Iversen, Esben
AU - Nguyen, Camilla Ngoc
AU - Kallemose, Thomas
AU - Juul‐larsen, Helle Gybel
AU - Jawad, Baker Nawfal
AU - Hornum, Mads
AU - Andersen, Ove
AU - Eugen‐olsen, Jesper
AU - Houlind, Morten Baltzer
N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021
Y1 - 2021
N2 - 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 (n = 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 (p = 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.
AB - 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 (n = 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 (p = 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.
KW - Acute kidney injury
KW - Early biomarker
KW - Emergency department
KW - Medication optimization
KW - Older patients
KW - Plasma neutrophil gelatinase‐associated lipocalin
KW - Soluble urokinase plasminogen activator receptor
U2 - 10.3390/ph14090843
DO - 10.3390/ph14090843
M3 - Journal article
C2 - 34577543
AN - SCOPUS:85114029211
VL - 14
JO - Pharmaceuticals
JF - Pharmaceuticals
SN - 1424-8247
IS - 9
M1 - 843
ER -
ID: 279822032