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

Thu May 28 2020

Danish scientists reported in today’s New England Journal of Medicine that emergency department patients with suPAR levels over 4.3 ng/ml (top quartile) face a risk of developing kidney failure 23 times higher than those with suPAR levels below 2.0 ng/ml (lowest quartile).

These findings both confirm and build upon earlier work by Hayek et al., showing suPAR as a widely relevant marker for predicting acute kidney injury and renal function decline.

Hayek and colleagues identified a link between high suPAR levels and an increased risk of acute kidney disease in individuals undergoing coronary angiography or cardiac surgery, and in intensive care unit patients.

Now, Copenhagen University Hospital Hvidovre researchers have found that high suPAR levels also indicate acute kidney injury risk in acute medical patients. Since 2013, the hospital has used suPAR as a standard measure of disease severity and progression in these patients. They examined suPAR levels and the risk of acute kidney disease in over 25,000 patients without prior kidney disease.

Their analysis revealed that patients with suPAR levels above 4.3 ng/mL were 23 times more likely to develop acute kidney injury than those with levels below 2.0 ng/mL.

This research broadens the implications of Hayek et al.’s work, positioning suPAR as a key indicator for acute kidney injury and renal function deterioration across various patient groups: those undergoing heart procedures, in intensive care, and now, emergency department patients.

Dr. Jesper Eugen-Olsen emphasized the value of suPAR in risk classification for identifying high-risk acute medical patients. Early clinical interventions could prevent kidney disease progression and other complications, according to his statement.

The study, titled “suPAR and Acute Kidney Injury” by Iversen E, Houlind MB, and Eugen-Olsen J, appears in N Engl J Med 382;22, with the DOI: 10.1056/NEJMc2003613.

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