Sepsis-related acute kidney injury (AKI) is a common and serious complication of sepsis, with a high mortality rate. Early identification of patients at risk of renal non-recovery is crucial for guiding treatment decisions and improving outcomes. In recent years, urinary biomarkers have emerged as promising tools for predicting renal recovery in patients with AKI.
A recent study published in BMC Nephrology sought to evaluate the predictive accuracy of two urinary biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1), for renal non-recovery in patients with sepsis-related AKI. The study was a prospective observational study that included 120 patients with sepsis-related AKI who were admitted to the intensive care unit.
The researchers measured urinary levels of NGAL and KIM-1 within 24 hours of AKI diagnosis and followed the patients for 90 days to assess renal recovery. Renal non-recovery was defined as persistent renal dysfunction or the need for renal replacement therapy at 90 days.
The results of the study showed that both NGAL and KIM-1 were significantly higher in patients who did not achieve renal recovery compared to those who did. The area under the receiver operating characteristic curve (AUC) for NGAL was 0.78, indicating good predictive accuracy, while the AUC for KIM-1 was 0.72, indicating fair predictive accuracy.
These findings suggest that urinary biomarkers, particularly NGAL, may be useful for predicting renal non-recovery in patients with sepsis-related AKI. Early identification of patients at risk of renal non-recovery could help clinicians tailor treatment strategies and improve outcomes in this high-risk population.
It is important to note that this study had some limitations, including a relatively small sample size and a single-center design. Further research is needed to validate these findings in larger, multicenter studies and to determine the optimal cutoff values for NGAL and KIM-1 in predicting renal non-recovery in sepsis-related AKI.
In conclusion, the findings of this study suggest that urinary biomarkers, particularly NGAL, may have potential as predictive tools for renal non-recovery in patients with sepsis-related AKI. Further research is needed to confirm these findings and to determine the clinical utility of these biomarkers in guiding treatment decisions for patients with sepsis-related AKI.