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Updated: Aug 5, 2025
09:02
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Joint Modeling of Clinical and Biomarker Data in Acute Kidney Injury Defines Unique Subphenotypes with Differing
George Vasquez-Rios1, Wonsuk Oh2,3, Samuel Lee4
1Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Summary
Researchers identified four distinct acute kidney injury (AKI) subphenotypes using comprehensive biomarker data. These AKI subphenotypes show varied clinical features and predict different patient outcomes, including mortality and cardiorenal events.
Area of Science:
- Nephrology
- Biomarker Discovery
- Clinical Research
Background:
- Acute kidney injury (AKI) is a complex syndrome with significant heterogeneity.
- Current methods for AKI subphenotyping rely on limited laboratory data, hindering a comprehensive understanding.
Purpose of the Study:
- To develop a more detailed subphenotyping of AKI using a broader range of biomarkers.
- To investigate the clinical differences and prognostic implications of identified AKI subphenotypes.
Main Methods:
- Utilized hierarchical clustering with Ward linkage on biomarkers of inflammation, injury, and repair in 748 AKI patients from the ASSESS-AKI cohort.
- Analyzed clinical characteristics and longitudinal outcomes, including cardiorenal events and death, using Cox proportional hazard models.
Main Results:
- Identified four distinct AKI subphenotypes (N=181, 250, 159, 158) with unique biomarker profiles (e.g., KIM-1, uromodulin, BNP, YKL-40).
- Subphenotypes 3 and 4 showed increased mortality risk compared to subphenotype 2 (aHR 2.9 and 1.6, respectively).
- Subphenotype 3 was associated with a three-fold increased risk of chronic kidney disease (CKD) and cardiovascular events.
Conclusions:
- Four AKI subphenotypes were discovered, characterized by distinct clinical features and biomarker profiles.
- These subphenotypes are significantly associated with varying longitudinal clinical outcomes, including mortality and cardiorenal disease progression.
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