Up to 10% of patients who are hospitalized or undergo surgery will experience acute kidney injury (AKI), and as many as 50% of patients in intensive care units will meet the criteria for AKI, the National Kidney Foundation has determined. Some of these patients will progress to kidney failure within months.
Physician-Scientists and other researchers at Rush University Medical Center, in collaboration with colleagues at other institutions, have revealed a new treatment target that may help change the outcome for patients at risk of AKI. The results were published in Jan. 29 in The New England Journal of Medicine .
In this study, we found evidence that a specific protein produced by immune cells in the bone marrow, called soluble urokinase plasminogen activator receptor (suPAR,) is a strong risk factor for acute forms of kidney failure, that occur as consequence of general medical procedures." Jochen Reiser, MD, PhD, professor at Rush University Medical Center and chairperson of Rush's Department of Internal Medicine
Reiser is senior author of the study.
suPAR has been repeatedly shown to harm kidneys. Chronically elevated blood levels are linked to development of Chronic Kidney Disease (CKD), a paper published by Reiser and colleagues in The New England Journal of Medicine in 2015. Now, the new paper is showing that having elevated suPAR levels is also a risk factor for acute kidney inury - a sudden decline in kidney function that can be a severe side effect of general medical procedures.
"Nephrology has found its global risk molecule: suPAR," said Reiser.
"Any kidney disease, chronic or acute, genetic or acquired, is better off with a lower suPAR level. By looking at suPAR levels in patients, we can possibly prevent damage to healthy kidneys that is often irreversible."
Reiser believes that high suPAR levels will inform physician-patient conversations about preventing kidney disease, just as high cholesterol levels signal the need for lifestyle changes and protective drugs, such as statins, to avert heart attacks and strokes. Study looked at SuPAR levels in coronary angiography, cardiac surgery and ICU patients
We have known for some time now of suPAR's important role in kidney disease. Here we show that suPAR is relevant in important clinical situations such as coronary angiography and cardiac surgery, and could be targeted to minimize the risk of AKI." Salim Hayek, MD, cardiologist at the Michigan Medicine Frankel Cardiovascular Center and first author of the study
Reiser, Hayek and colleagues performed a two-pronged investigation of suPAR.
First, they looked at suPAR levels and the risk of acute kidney injury in three clinical settings.
We collected blood samples from patients about to undergo coronary angiography for suspected heart disease, patients undergoing cardiac surgery, and critically ill patients who had been admitted to the intensive care unit." David E. Leaf, MD, co-first author on the study and the director acute kidney injury research at Brigham and Women's Hospital of Harvard Medical School Related Stories
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