Related Experiment Video

Updated: Sep 12, 2025

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection
10:15

Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection

Published on: November 10, 2021

1.9K

CLEAVAGE OF IGFBP-1 BY AN ENZYME IN URINE PREDICTS THE FUTURE NEED FOR KIDNEY REPLACEMENT THERAPY IN ACUTE KIDNEY

John M Arthur1, Joseph H Holthoff1

  • 1Little Rock, AR.

Transactions of the American Clinical and Climatological Association
|August 7, 2025
PubMed

Insights

A new biomarker, cleaved insulin-like growth factor-binding protein 1 (IGFBP-1), shows promise for predicting severe acute kidney injury (AKI) progression to dialysis with 100% sensitivity and a low false positive rate.

Area of Science:

  • Biochemistry
  • Nephrology
  • Biomarker Discovery

Background:

  • Current Food and Drug Administration (FDA)-approved biomarkers for acute kidney injury (AKI) exhibit a 50% false positive rate (FPR).
  • Insulin-like growth factor-binding protein 1 (IGFBP-1) has been identified as a potential predictor of severe AKI.

Purpose of the Study:

  • To evaluate the efficacy of IGFBP-1 cleavage in urine as a biomarker for predicting the progression of AKI to the point of requiring dialysis.
  • To assess the sensitivity and FPR of IGFBP-1 cleavage in various stages of AKI.

Main Methods:

  • Urine samples were analyzed for the cleavage of IGFBP-1, an enzyme-mediated process.
  • The study included patients with stage 1 AKI who progressed to dialysis, healthy controls, and patients with varying stages of AKI who did not require dialysis.

Main Results:

  • Urine IGFBP-1 cleavage demonstrated 100% sensitivity in predicting progression to dialysis among patients with stage 1 AKI.
  • The FPR was 0% in healthy controls.
  • FPRs varied among patients with stage 1 AKI: 11% (no progression), 15% (stage 2), and 50% (stage 3 without dialysis).

Conclusions:

  • Cleaved IGFBP-1 shows high potential as a sensitive biomarker for predicting AKI progression to dialysis.
  • In a typical intensive care unit (ICU) setting, a test based on IGFBP-1 cleavage could achieve 100% sensitivity and a 6% FPR.

More Related Videos

Transdermal Measurement of Glomerular Filtration Rate in Mice07:25

Transdermal Measurement of Glomerular Filtration Rate in Mice

Published on: October 21, 2018

22.2K
Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis04:37

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis

Published on: April 25, 2025

777

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
74
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
45
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
76
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
94
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
80