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Method for the early identification and prediction of kidney injury

a kidney injury and early detection technology, applied in the field of early identification and prediction of kidney damage, can solve the problems of dialysis, no drug therapy available, and patients will require rrt,

Inactive Publication Date: 2009-09-24
ARGUTUS INTPROP
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0021]Preferably, the biomarker is detectable as early as intraoperatively, allowing for immediate corrective medical intervention.
[0022]The method according to the invention, by providing a means of detecting damage to, and predicting the extent of damage to, the kidney as early as intraoperatively represents a very significant advance in the management and treatment of patients undergoing CT surgery.
[0023]According to one embodiment of the invention, the biomarker is detectable in the recovery stage post CT surgery, allowing for immediate corrective medical intervention.
[0030]Thus, it will be appreciated that use of the method according to the invention can result in a significant reduction of the deleterious side effects of renal ischemia in a patient undergoing CT surgery.

Problems solved by technology

Currently no drug therapy is available for counteracting the effects of a reduction in kidney function as seen, for example in post CT surgery.
However, as indicated above, frequently, if such measures do not prove successful, the patient will require RRT, namely dialysis.

Method used

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  • Method for the early identification and prediction of kidney injury
  • Method for the early identification and prediction of kidney injury
  • Method for the early identification and prediction of kidney injury

Examples

Experimental program
Comparison scheme
Effect test

example 1

Use of πGST as a Biomarker for AKI in Patients Undergoing CT Surgery

[0068]A retrospective study of 68 patients who had undergone elective CT surgery at the University of Chicago Hospital was carried out.

[0069]The patients were screened and approached for enrollment. The patients were excluded if they met any of the following criteria:

Pre-existing End Stage Renal Disease (ESRD) (on RRT) or Renal Transplant.

[0070]Age <18 years old.

Use of radiocontrast within 24 hours of surgery.

Change in thyroid hormone replacement dose in the last 2 weeks

Change in thyroid chronic corticosteroids dose in the last 2 weeks

Unstable renal function (Δ Serum Creatinine ≧0.2 mg / dl in the last 2 months of Oliguria defined as <400 ml / day).

[0071]Urine and blood samples were collected and stored.

[0072]The urine samples were tested for the presence of πGST using the aforementioned πGST EIA available from Biotrin International Limited (Catalogue Number BIO85).

[0073]Serum Creatinine (SCr) was measured using the Jaf...

example 2

Use of πGST as a Biomarker for a Requirement for RRT Patients Undergoing CT Surgery

[0085]A study was carried out on the 68 patients, the subject of Example 1, using the same methodology for the detection of SCr and πGST.

[0086]Seven patients out of the 68 patients tested required RRT. The results are shown in Table 2.

TABLE 2BaselineCreatinineHours inCreatinineat RRTICU prior(mg / dL)(mg / dL)to RRTIndication15.035.425.3Refractory Hyperkalemia (6.0), Oliguria21.493.4851.2Anuria, Elevated creatinine, Shock1.36 post-op31.31.4221.6Volume overload, Hypoxia, Oliguria, Hemodynamic instability*AKI not diagnosed using current SCr measures*41.23.7926.8Lactic Acidosis Oliguria, Shock, Elevated creatinine50.991.283Lactic Acidosis Anuria, Shock,*AKI not diagnosed using current SCr measures*61.191.745.3Anuria, Shock (3 pressors), Volume overload. Acidosis71.662.881Volume overload, pulmonary edema. Shock

[0087]The time point at which patients requiring RRT would be first diagnosed is shown in Table 3.

TA...

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Abstract

A method for the early identification and prediction of elevated blood creatinine levels resulting from a reduction in kidney function in a subject, comprises contacting a urine sample from the subject with a capture molecule for a biomarker specific for the distal region of the renal tubule and which biomarker is released from said region when there is damage to said region indicative and predictive of elevated blood creatinine levels resulting from a reduction in kidney function. The method can be used to detect Acute Kidney Injury (AKI) caused by many conditions or diseases or through the administration of drugs. The method can indicate and / or predict a reduction in kidney function significantly earlier than the current standard creatinine test. Methods for predicting a need for renal replacement therapy (RRT) are also disclosed.

Description

TECHNICAL FIELD[0001]This invention relates to the early identification and prediction of kidney damage, including early identification and prediction of elevated blood creatinine levels resulting from a reduction in kidney function in a subject and, in particular, to biomarkers for the detection thereof.BACKGROUND ART[0002]There are many causes of a reduction in kidney function and it is essential that corrective action is taken as early as possible by appropriate medical intervention so as to minimise as far as possible the deleterious consequences, which include total renal failure and a need for dialysis and ultimately kidney transplant. For example, an abrupt reduction in kidney function occurs frequently following cardiothoracic (CT) surgery. Thus, Acute Kidney Injury (AKI) is common following CT surgery occurring in 7-42% of patients (Mora Mangano, C. et al (1998) Ann Intern Med 128:194-203; and Tuttle, K. R. et al (2003) Amer J. Kid Dis 41:76-83.) Small changes in serum crea...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): G01N33/573G01N33/53C12N9/10
CPCG01N33/6893G01N2800/347G01N2333/91177
Inventor KILTY, CORMAC GERALDKOYNER, JAY LAWRENCEMCGRATH, CLAIRE VICTORIAMURRAY, PATRICK THOMASSCHUSTER, KERSTIN
Owner ARGUTUS INTPROP
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