Proadrenomedullin as indicator for renal replacement therapy in critically ill patients

An adrenomedullin and critical technology, applied in disease diagnosis, instrumentation, biomaterial analysis, etc., can solve problems such as shortage

CN111065922APending Publication Date: 2020-04-24BRAHMS GMBH
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Patent Information

Authority / Receiving Office
CN · China
Patent Type
Applications(China)
Current Assignee / Owner
Publication Date
2020-04-24

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Abstract

The present invention relates to a method for assessing whether a critically ill subject is in need of a renal replacement therapy, wherein the method comprises determining in a sample obtained from said subject the level of proadrenomedullin (proADM) or a fragment thereof, preferably the fragment is MR-proADM, wherein said level of proADM or the fragment thereof is indicative of a need of said subject to receive a renal replacement therapy.
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Description

technical field

[0001] The present invention relates to a method for assessing the need for renal replacement therapy in a critically ill subject. The assessment is based on the level of proadrenomedullin (proADM) or a fragment thereof, such as MR-proADM, in the subject's sample. Background technique

[0002] Intensive care professionals are challenged every day to provide the best quality of care for critically ill patients at high risk of dying most often from multiple organ dysfunction syndrome (MODS) (Mayr, V.D., M.W. Dünser et al. (2006), Crit Care 10(6):R154). Renal dysfunction constitutes an important component in MODS and renal support is increasingly used routinely in the intensive care unit (ICU). Sepsis is a major cause of acute renal failure in critically ill patients (Bagshaw, S.M., S. Uchino et al. (2007), Clin J Am Soc Nephrol 2(3):431-439). About half of all patients with septic shock develop renal failure, which is associated with an increased mortality r...

Examples

Embodiment

[0092] The examples have been carried out by detecting MR-proADM. However, as outlined above, the present invention can also be performed by detecting proADM or additional peptide fragments thereof.

[0093] Research design

[0094]A total of 1089 intensive care unit (ICU) patients were recruited into the study, of which 142 (13.0%) had severe sepsis and 947 (87.0%) had septic shock. The 28-day mortality rate was 26.9% and the hospital mortality rate was 33.4%. 321 (29.8%) patients required renal replacement therapy (RRT) within the first 28 days of ICU treatment, with the vast majority (N = 296; 92.2%) requiring RRT for the first time within the first 7 days of treatment

[0095] - Baseline: 178 (16.6%)

[0096] - Day 1: 59 (6.7%)

[0097] - Day 2: 25 (3.2%)

[0098] - Day 3: 11 (1.6%)

[0099] A trend of increased 28-day or 90-day mortality based on the time of initiation of RRT was found:

[0100] - 28-day and 90-day mortality at baseline: 52.2% and 63.2%;

[0101]...