Identification and validation of biomarkers of persistent acute kidney injury: the RUBY study
Year: 2020
Type: article
Study design: Observational Study
Abstract: PURPOSE: The aim of the RUBY study was to evaluate novel candidate biomarkers to enable prediction of persistence of renal dysfunction as well as further understand potential mechanisms of kidney tissue damage and repair in acute kidney injury (AKI). METHODS: The RUBY study was a multi-center international prospective observational study to identify biomarkers of the persistence of stage 3 AKI as defined by the KDIGO criteria. Patients in the intensive care unit (ICU) with moderate or severe AKI (KDIGO stage 2 or 3) were enrolled. Patients were to be enrolled within 36 h of meeting KDIGO stage 2 criteria. The primary study endpoint was the development of persistent severe AKI (KDIGO stage 3) lasting for 72 h or more (NCT01868724). RESULTS: 364 patients were enrolled of whom 331 (91%) were available for the primary analysis. One hundred ten (33%) of the analysis cohort met the primary endpoint of persistent stage 3 AKI. Of the biomarkers tested in this study, urinary C-C motif chemokine ligand 14 (CCL14) was the most predictive of persistent stage 3 AKI with an area under the receiver operating characteristic curve (AUC) (95% CI) of 0.83 (0.78-0.87). This AUC was significantly greater than values for other biomarkers associated with AKI including urinary KIM-1, plasma cystatin C, and urinary NGAL, none of which achieved an AUC > 0.75. CONCLUSION: Elevated urinary CCL14 predicts persistent AKI in a large heterogeneous cohort of critically ill patients with severe AKI. The discovery of CCL14 as a predictor of persistent AKI and thus, renal non-recovery, is novel and could help identify new therapeutic approaches to AKI.
Source: Intensive Care Medicine
Authors: the RUBY Investigators, Eric Hoste, Azra Bihorac, Ali Al-Khafaji, Luis M. Ortega, Marlies Ostermann, Michael Haase, Kai Zacharowski, Richard Wunderink, Michael Heung, Matthew Lissauer, Wesley H. Self, Jay L. Koyner, Patrick M. Honore, John R. Prowle, Michael Joannidis, Lui G. Forni, J. Patrick Kampf, Paul McPherson, John A. Kellum, Lakhmir S. Chawla
Institutions: Ghent University Hospital, University of Florida, University of Pittsburgh, Allegheny General Hospital, St Thomas' Hospital, King's College London, Otto-von-Guericke-Universität Magdeburg, Goethe University Frankfurt, University Hospital Frankfurt, German University of Digital Science, Northwestern University, University of Michigan, Michigan Medicine, Rutgers, The State University of New Jersey, Vanderbilt University Medical Center, University of Chicago, Universitair Ziekenhuis Brussel, Barts Health NHS Trust, Royal London Hospital, Innsbruck Medical University, Universität Innsbruck, University of Surrey, Astute Medical (United States), United States Department of Veterans Affairs, Veterans Health Administration, VA San Diego Healthcare System
Language: English
Topic: Acute Kidney Injury Research
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,480
Funders: U.S. Department of Veterans Affairs, Vanderbilt University, Northwestern University, George Washington University, Cleveland Clinic, Cleveland Clinic Foundation, University of Pittsburgh, Astute Medical, Vanderbilt University Medical Center, Northeast Ohio Medical University, King's College London, Universitair Ziekenhuis Gent, University of Surrey, Universiteit Gent, Universitat de Barcelona, Universitat Autònoma de Barcelona, Barts Health NHS Trust, School of Medicine, Duke University, Feinberg School of Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases
OpenAlex ID: W3005099669