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J Nephropathol. 2016;5(2): 65-71.
doi: 10.15171/jnp.2016.13
PMID: 27152292
PMCID: PMC4844911
Scopus ID: 84963603086
  Abstract View: 3548
  PDF Download: 1624

Original Article

DDRGK1 in urine indicative of tubular cell injury in intensive care patients with serious infections

Dashurie Neziri 1, Sahra Pajenda 1, Rebecca Amuge 2, Aysegul Ilhan 1, Marlene Wewalka 3, Gregor Hörmann 4, Christian Zauner 3, Ludwig Wagner 1*

1 Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
2 Ugandan Christian University of Mbale, Mbale, Uganda
3 Division of Intensive Care 13H1, Medical University of Vienna, Vienna, Austria
4 Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
*Corresponding Author: *Corresponding author: Ludwig Wagner MD, Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Waehringer Guertel, Vienna, Austria. , Email: Ludwig.Wagner@meduniwien.ac.at

Abstract

Background: Acute kidney injury (AKI) is a life threatening condition. Despite intensive care treatment the occurrence cannot be predicted as very little indicators exist for direct measurement when tubular epithelial cell injury takes place. We therefore searched for novel peptide indicators expressed at intracellular level at the proximal kidney tubule for its appearance in urine samples.

Objectives: Establishing a test for urinary C20orf116 protein measurement.

Patients and Methods: Generation of immunoreagents against C20orf116 also named DDRGK1. These were used to measure its presence in urine collected at 8-24 hours interval in a prospective study from 99 ICU patients at 4-6 time points. These patients received therapy because of serious infection and were categorized into 4 groups.

Results: 1) Ten tested highly for C20orf116 undergoing AKI graded Failure or Loss (3210 ± 4268 ng/mL) according to RIFLE criteria, all requiring renal replacement therapy (RRT) out of them 9 died. 2) Six patients with pre-existing kidney disease developed AKI and required RRT but had much lower C20orf116 levels of (33 ± 19), two of them died. 3) In contrast, out of 11 patients undergoing AKI grade Risk or Injury, four tested positive for C20orf116 but to much lower extent (66 ± 43) who recovered fully. 4) Out of 72 patients 25 tested positive (18 ± 12 ng/mL) not fulfilling criteria of AKI but with serum creatinine (sCr) rises of 1.2-1.4 (n = 52). Healthy donors (n = 48) showed no detectable C20orf116 at any time point.

Conclusions:C20orf116 excretion was detectable more than 24 hours before sCr rise could be measured; high level seemed to indicate severity of organ failure.


Implication for health policy/practice/research/medical education:

Protein biomarker testing in urine for patients presenting with morbidities associated with high risk to undergo acute kidney injury (AKI) is a new option for early diagnosis of kidney stress und would therefore be helpful to mitigate injuries by early intervention strategies.

Please cite this paper as:Neziri D, Pajenda S, Amuge R, Ilhan A, Wewalka M, Hörmann G, et al. DDRGK1 in urine indicative of tubular cell injury in intensive care patients with serious infections. J Nephropathol. 2016;5(2):65-71. DOI: 10.15171/ jnp.2016.13

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ePublished: 31 Mar 2016
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