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The potential use of biomarkers in predicting contrast-induced acute kidney injury
Michele Andreucci1, Teresa Faga1, Eleonora Riccio2
1Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro.
Insights
Diagnosing contrast-induced acute kidney injury (CI-AKI) needs better biomarkers than creatinine. New markers like L-FABP and Cys-C show promise for earlier detection and improved patient outcomes.
Area of Science:
- Nephrology
- Radiology
- Biomarker Discovery
Background:
- Contrast-induced acute kidney injury (CI-AKI) is a significant complication of iodinated contrast media, particularly in patients with renal failure.
- CI-AKI contributes to 12% of hospital-acquired kidney failure, prolonging hospital stays and increasing healthcare burdens.
- Current diagnostic methods relying on creatinine levels are late indicators of kidney damage, highlighting the need for earlier detection strategies.
Purpose of the Study:
- To review and discuss novel biomarkers for the early and reliable detection of CI-AKI.
- To evaluate the potential of various biomarkers in established CI-AKI models and clinical studies.
- To explore the emerging roles of miRNA and metabolomic technologies in CI-AKI diagnostics.
Main Methods:
- Literature review of characterized biomarkers for acute kidney injury (AKI) in the context of CI-AKI.
- Discussion of specific biomarkers including neutrophil gelatinase-associated lipocalin, cystatin C (Cys-C), kidney injury molecule-1, interleukin-18, N-acetyl-β-d-glucosaminidase, and L-type fatty acid-binding protein (L-FABP).
- Exploration of advanced diagnostic technologies such as miRNA and metabolomics.
Main Results:
- Several novel biomarkers have been identified and characterized for AKI, with potential application in CI-AKI.
- Biomarkers such as L-FABP and Cys-C have shown promise in CI-AKI models and studies.
- miRNA and metabolomic technologies present emerging avenues for CI-AKI detection.
Conclusions:
- Early detection of CI-AKI is crucial for timely intervention and improved patient outcomes.
- Novel biomarkers offer a more reliable and sensitive approach compared to traditional creatinine monitoring.
- A combination of biomarkers and advancements in analytical technology may provide effective future diagnostic solutions for CI-AKI.
Abstract:
Contrast-induced acute kidney injury (CI-AKI) is a problem associated with the use of iodinated contrast media, causing kidney dysfunction in patients with preexisting renal failure. It accounts for 12% of all hospital-acquired kidney failure and increases the length of hospitalization, a situation that is worsening with increasing numbers of patients with comorbidities, including those requiring cardiovascular interventional procedures. So far, its diagnosis has relied upon the rise in creatinine levels, which is a late marker of kidney damage and is believed to be inadequate. Therefore, there is an urgent need for biomarkers that can detect CI-AKI sooner and more reliably. In recent years, many new biomarkers have been characterized for AKI, and these are discussed particularly with their use in known CI-AKI models and studies and include neutrophil gelatinase-associated lipocalin, cystatin C (Cys-C), kidney injury molecule-1, interleukin-18, N-acetyl-β-d-glucosaminidase, and L-type fatty acid-binding protein (L-FABP). The potential of miRNA and metabolomic technology is also mentioned. Early detection of CI-AKI may lead to early intervention and therefore improve patient outcome, and in future any one or a combination of several of these markers together with development in technology for their analysis may prove effective in this respect.
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