suPAR and prediction of Acute Kidney Injury in New England Journal of Medicine

Thu May 28 2020

In today’s New England Journal of Medicine, Danish scientists show that patients presenting in the Emergency Department with elevated suPAR (> 4.3 ng/ml, top quartile) have 23 times higher risk for development of kidney failure compared to those with low suPAR (< 2.0 ng/ml, lowest quartile).

These results verify and extend previous findings by Hayek at al., indicating that suPAR is a broadly applicable marker for predicting the development of acute kidney injury and decline in renal function.

Hayek and coworkers found that elevated suPAR is associated with increased risk of developing acute kidney disease in patients undergoing coronary angiography or cardiac surgery and in patients admitted to the intensive care unit.

Researchers from Copenhagen University Hospital Hvidovre now show that elevated suPAR also is associated with acute kidney injury in acute medical patients. At the hospital, suPAR has been a routine biomarker of disease severity and progression in acute medical patients since 2013. The researchers analysed suPAR and the risk of developing acute kidney disease in patients with unplanned hospital admission, and data from more than 25.000 patients without prior kidney disease was included.

Results showed, that patients with suPAR level > 4.3 ng/mL had a 23-fold higher risk for development of acute kidney injury, than for those patients with a suPAR level < 2,0 ng/mL.

These data extend the findings by Hayek et al. and suggest that the suPAR level is a broadly applicable marker for the development of acute kidney injury and decline in renal function in various different patients groups; patients undergoing coronary angiography or cardiac surgery, in the intensive care unit, and, as shown now, in patients in the emergency department.

Dr. Jesper Eugen-Olsen says ”Our findings highlight the potential for using suPAR in risk classification to identify high-risk acute medical patients who could benefit from early clinical interventions to prevent progression to kidney disease and avoid other complications.”

“suPAR and Acute Kidney Injury” by Iversen E, Houlind MB and Eugen-Olsen J, N Engl J Med 382;22,
DOI: 10.1056/NEJMc2003613

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