January 30, 2020
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Biomarker may predict AKI following common medical procedures

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Higher levels of a signaling glycoprotein were associated with acute kidney injury in patients who underwent coronary angiography or cardiac surgery, according to study results.

In a press release, primary investigator Salim S. Hayek, MD, of the University of Michigan, said, “[Soluble urokinase plasminogen activator receptor] suPAR reflects a process that physicians are unable to account for in traditional assessments of kidney disease. We believe this protein acts as the link between inflammation and kidney disease, both chronic and acute.”

Writing that AKI most commonly occurs in critically ill patients or in those with cardiovascular disease — as members of these populations are at increased risk due to older age, coexisting conditions and greater likelihood of undergoing medical procedures that affect the kidneys — Hayek and colleagues wanted to explore new therapeutic targets that could be used in preventive strategies.

The researchers measured plasma levels of suPAR in 3,827 patients before coronary angiography and in 250 patients before cardiac surgery. Levels of suPAR were divided into quartiles.

Results showed that, among patients who underwent coronary angiography, those in the highest suPAR quartile had an adjusted odds ratio of 2.66 for AKI and 2.29 for AKI or death at 90 days vs. those in the lowest quartile. Similar results were observed in patients who underwent cardiac surgery, with the incidence of AKI being 40% for those in the highest quartile compared with 16% in the lowest.

Kidneys 
Higher levels of a signaling glycoprotein were associated with acute kidney injury.
Source: Adobe Stock

“This measure could be employed to figure out who’s at the highest risk of disease progression or of kidney-related procedural complications, which is currently difficult to determine in clinical practice,” Hayek said in the press release. “Now that we have extensive data on a role for suPAR in causing kidney disease, we can envision using suPAR-reducing therapies in patients at risk of both chronic and acute kidney disease.”

He added, “After decades with little progress in the management of kidney disease, we have on our hands a promising new target to prevent acute kidney injury.” – by Melissa J. Webb

Disclosures: Hayek reports a patent PCT/US2019/053802-suPAR and Prediction and Treatment of Acute Kidney Injury pending. Please see full study for all other authors’ relevant financial disclosures.