Urinary biomarkers in the early diagnosis of acute kidney injury

W. K. Han, S. S. Waikar, A. Johnson, Rebecca Betensky, C. L. Dent, P. Devarajan, J. V. Bonventre

Research output: Contribution to journalArticle

Abstract

A change in the serum creatinine is not sensitive for an early diagnosis of acute kidney injury. We evaluated urinary levels of matrix metalloproteinase-9 (MMP-9), N-acetyl-β-D-glucosaminidase (NAG), and kidney injury molecule-1 (KIM-1) as biomarkers for the detection of acute kidney injury. Urine samples were collected from 44 patients with various acute and chronic kidney diseases, and from 30 normal subjects in a cross-sectional study. A case-control study of children undergoing cardio-pulmonary bypass surgery included urine specimens from each of 20 patients without and with acute kidney injury. Injury was defined as a greater than 50% increase in the serum creatinine within the first 48 h after surgery. The biomarkers were normalized to the urinary creatinine concentration at 12, 24, and 36 h after surgery with the areas under the receiver-operating characteristic curve compared for performance. In the cross-sectional study, the area under the curve for MMP-9 was least sensitive followed by KIM-1 and NAG. Combining all three biomarkers achieved a perfect score diagnosing acute kidney injury. In the case-control study, KIM-1 was better than NAG at all time points, but combining both was no better than KIM-1 alone. Urinary MMP-9 was not a sensitive marker in the case-control study. Our results suggest that urinary biomarkers allow diagnosis of acute kidney injury earlier than a rise in serum creatinine.

Original languageEnglish (US)
Pages (from-to)863-869
Number of pages7
JournalKidney International
Volume73
Issue number7
DOIs
StatePublished - Jan 1 2008

Fingerprint

Acute Kidney Injury
Early Diagnosis
Hexosaminidases
Biomarkers
Creatinine
Matrix Metalloproteinase 9
Wounds and Injuries
Kidney
Case-Control Studies
Cross-Sectional Studies
Serum
Urine
Chronic Renal Insufficiency
ROC Curve
Area Under Curve
Lung

Keywords

  • Acute kidney injury
  • KIM-1
  • MMP-9
  • NAG

ASJC Scopus subject areas

  • Nephrology

Cite this

Han, W. K., Waikar, S. S., Johnson, A., Betensky, R., Dent, C. L., Devarajan, P., & Bonventre, J. V. (2008). Urinary biomarkers in the early diagnosis of acute kidney injury. Kidney International, 73(7), 863-869. https://doi.org/10.1038/sj.ki.5002715

Urinary biomarkers in the early diagnosis of acute kidney injury. / Han, W. K.; Waikar, S. S.; Johnson, A.; Betensky, Rebecca; Dent, C. L.; Devarajan, P.; Bonventre, J. V.

In: Kidney International, Vol. 73, No. 7, 01.01.2008, p. 863-869.

Research output: Contribution to journalArticle

Han, WK, Waikar, SS, Johnson, A, Betensky, R, Dent, CL, Devarajan, P & Bonventre, JV 2008, 'Urinary biomarkers in the early diagnosis of acute kidney injury', Kidney International, vol. 73, no. 7, pp. 863-869. https://doi.org/10.1038/sj.ki.5002715
Han, W. K. ; Waikar, S. S. ; Johnson, A. ; Betensky, Rebecca ; Dent, C. L. ; Devarajan, P. ; Bonventre, J. V. / Urinary biomarkers in the early diagnosis of acute kidney injury. In: Kidney International. 2008 ; Vol. 73, No. 7. pp. 863-869.
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