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
Subjects:	R Medicine (General)
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
_version_	1777408043426775040

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

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