Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury

The concentration of urine influences the concentration of urinary biomarkers of AKI. Whether normalization to urinary creatinine concentration, as commonly performed to quantitate albuminuria, is the best method to account for variations in urinary biomarker concentration among patients in the inte...

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Main Authors: Md Ralib, Azrina, Pickering, John W., Shaw, Geoffrey M., Devarajah, Prasad, Edelstein, Charles L., Bonventre, Joseph V., Endre, Zoltan H.
Format: Article
Language:English
Published: American Society of Nephrology 2012
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Online Access:http://irep.iium.edu.my/10612/
http://irep.iium.edu.my/10612/
http://irep.iium.edu.my/10612/
http://irep.iium.edu.my/10612/1/Journal_of_the_American_Society_of_Nephrology_2011_Md_Ralib.pdf
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spelling iium-106122014-07-17T03:02:52Z http://irep.iium.edu.my/10612/ Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury Md Ralib, Azrina Pickering, John W. Shaw, Geoffrey M. Devarajah, Prasad Edelstein, Charles L. Bonventre, Joseph V. Endre, Zoltan H. R Medicine (General) The concentration of urine influences the concentration of urinary biomarkers of AKI. Whether normalization to urinary creatinine concentration, as commonly performed to quantitate albuminuria, is the best method to account for variations in urinary biomarker concentration among patients in the intensive care unit is unknown. Here, we compared the diagnostic and prognostic performance of three methods of biomarker quantitation: absolute concentration, biomarker normalized to urinary creatinine concentration, and biomarker excretion rate. We measured urinary concentrations of alkaline phosphatase, gamma-glutamyl transpeptidase, cystatin C, neutrophil gelatinase–associated lipocalin, kidney injury molecule–1, and IL-18 in 528 patients on admission and after 12 and 24 hours. Absolute concentration best diagnosed AKI on admission, but normalized concentrations best predicted death, dialysis, or subsequent development of AKI. Excretion rate on admission did not diagnose or predict outcomes better than either absolute or normalized concentration. Estimated 24-hour biomarker excretion associated with AKI severity, and for neutrophil gelatinase–associated lipocalin and cystatin C, with poorer survival. In summary, normalization to urinary creatinine concentration improves the prediction of incipient AKI and outcome but provides no advantage in diagnosing established AKI. The ideal method for quantitating biomarkers of urinary AKI depends on the outcome of interest. American Society of Nephrology 2012-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/10612/1/Journal_of_the_American_Society_of_Nephrology_2011_Md_Ralib.pdf Md Ralib, Azrina and Pickering, John W. and Shaw, Geoffrey M. and Devarajah, Prasad and Edelstein, Charles L. and Bonventre, Joseph V. and Endre, Zoltan H. (2012) Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury. Journal of American Society of Nephrology, 23 (2). pp. 1-12. ISSN 1533-3450 (In Press) http://jasn.asnjournals.org/content/23/2/322.full.pdf+html 10.1681/ASN.2011040325
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Md Ralib, Azrina
Pickering, John W.
Shaw, Geoffrey M.
Devarajah, Prasad
Edelstein, Charles L.
Bonventre, Joseph V.
Endre, Zoltan H.
Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
description The concentration of urine influences the concentration of urinary biomarkers of AKI. Whether normalization to urinary creatinine concentration, as commonly performed to quantitate albuminuria, is the best method to account for variations in urinary biomarker concentration among patients in the intensive care unit is unknown. Here, we compared the diagnostic and prognostic performance of three methods of biomarker quantitation: absolute concentration, biomarker normalized to urinary creatinine concentration, and biomarker excretion rate. We measured urinary concentrations of alkaline phosphatase, gamma-glutamyl transpeptidase, cystatin C, neutrophil gelatinase–associated lipocalin, kidney injury molecule–1, and IL-18 in 528 patients on admission and after 12 and 24 hours. Absolute concentration best diagnosed AKI on admission, but normalized concentrations best predicted death, dialysis, or subsequent development of AKI. Excretion rate on admission did not diagnose or predict outcomes better than either absolute or normalized concentration. Estimated 24-hour biomarker excretion associated with AKI severity, and for neutrophil gelatinase–associated lipocalin and cystatin C, with poorer survival. In summary, normalization to urinary creatinine concentration improves the prediction of incipient AKI and outcome but provides no advantage in diagnosing established AKI. The ideal method for quantitating biomarkers of urinary AKI depends on the outcome of interest.
format Article
author Md Ralib, Azrina
Pickering, John W.
Shaw, Geoffrey M.
Devarajah, Prasad
Edelstein, Charles L.
Bonventre, Joseph V.
Endre, Zoltan H.
author_facet Md Ralib, Azrina
Pickering, John W.
Shaw, Geoffrey M.
Devarajah, Prasad
Edelstein, Charles L.
Bonventre, Joseph V.
Endre, Zoltan H.
author_sort Md Ralib, Azrina
title Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
title_short Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
title_full Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
title_fullStr Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
title_full_unstemmed Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
title_sort test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury
publisher American Society of Nephrology
publishDate 2012
url http://irep.iium.edu.my/10612/
http://irep.iium.edu.my/10612/
http://irep.iium.edu.my/10612/
http://irep.iium.edu.my/10612/1/Journal_of_the_American_Society_of_Nephrology_2011_Md_Ralib.pdf
first_indexed 2023-09-18T20:20:00Z
last_indexed 2023-09-18T20:20:00Z
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