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Changes in Novel AKI Biomarkers after Exercise. A Systematic Review
Wojciech Wołyniec1, Wojciech Ratkowski2, Joanna Renke3
1Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9b Powstania Styczniowego Street, 81-519 Gdynia, Poland.
International Journal of Molecular Sciences
|August 14, 2020
Summary
New biomarkers for acute kidney injury (AKI) show temporary increases after exercise in healthy adults. Cystatin C appears promising for monitoring kidney function in athletes, while other markers
Area of Science:
- Nephrology
- Exercise Physiology
- Biomarker Research
Background:
- Over 100 substances are identified as acute kidney injury (AKI) biomarkers, aiding early diagnosis when creatinine levels are normal.
- Cystatin C (kidney function) and neutrophil gelatinase-associated lipocalin (NGAL) (kidney damage) are key serum markers; numerous urinary markers like KIM-1, L-FABP, and IGFBP-7 also exist.
- Despite potential, many AKI biomarkers are not widely used clinically, with only IGFBP-7/TIMP-2 approved in some regions.
Purpose of the Study:
- To systematically review studies on changes in novel AKI biomarkers in healthy adults following single exercise sessions.
- To evaluate the reliability and interpretation of various AKI biomarkers in the context of physical exertion.
Main Methods:
- Systematic review of 27 identified papers.
- Analysis of studies investigating serum and urinary AKI biomarkers after exercise in healthy adults.
- Comparison of biomarker levels (e.g., cystatin C, NGAL, KIM-1) pre- and post-exercise.
Main Results:
- Cystatin C shows promise as a better indicator of glomerular filtration rate (GFR) in athletes post-exercise compared to creatinine.
- Serum NGAL increases after prolonged exercise, but its sensitivity to inflammation and hypoxia complicates AKI diagnosis; it may aid in detecting subclinical injury like rhabdomyolysis.
- Urinary biomarkers (NGAL, KIM-1, cystatin C, L-FABP, IL-18) rise after exercise but typically decrease rapidly, with their clinical significance for AKI remaining uncertain.
Conclusions:
- Cystatin C is a potentially valuable biomarker for assessing kidney function in athletes, even at rest.
- The transient elevations of many AKI biomarkers after exercise may represent physiological adaptation rather than actual kidney injury.
- Further research is needed to clarify the role and interpretation of exercise-induced changes in AKI biomarkers.
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