Biomarkers of Acute Renal Failure

Ongoing Mayo Clinic Clinical Validation Study

August 2009

We are currently completing a clinical validation study at Mayo Clinic, in order to determine optimal cutoff ranges to differentiate normal and disease. To do this, we are looking at urine samples from patients admitted from our emergency room. We will obtain traditional urinalysis, urinary electrolytes, and urinary NGAL levels. We will then determine clinical outcomes by retrospective review of the medical record. Key outcomes will be acute kidney injury by the AKIN criteria as well as mortality. The AKIN criteria were developed by the Acute Kidney Injury Network, and grade severity of acute kidney injury in stages 1-3 based upon degrees of elevation in creatinine and decreases in urinary output.

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Ongoing Clinical Validation Study

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Jump to section:

• Introduction
• Acute Kidney Injury
• Common Causes of Acute
• Progression From Pre-renal to Acute Tubular Necrosis
• Towards a Kidney Troponin
• Origin of Formed Elements in Urinalysis
• Urinanalysis: A Traditional Biomarker of AKI
• Hyaline Casts
• Renal Epithelial Cell Cast
• Leukocyte Cast
• RBC Cast
• Pigmented Cast
• Granular Cast
• Other Helpful Indices
• Potential Sources of Urinary Biomarkers
• NGAL as a Biomarker
• Studies Support NGAL as a Biomarker of AKI in the Following Situations
• Mayo Renal Laboratory Urinary NGAL Normals
• Normal Urinary NGAL Levels are Not Dependent on Age, but are Higher in Women than Men
• Ongoing Mayo Clinic Clinical Validation Study
• Ongoing Mayo Clinic Clinical Validation Study: Preliminary Results
• Study
• Other Potential Markers on the Horizon
• Mayo Clinic Goals
• Conclusions
• References
• Questions?