Increased urinary excretion of kynurenic acid is associated with non-recovery from acute kidney injury in critically ill patients

BMC Nephrology
Fabienne AreggerJoerg C Schefold

Abstract

Acute kidney injury (AKI) is often observed in critically ill patients and is associated with high morbidity and mortality. Non-recovery from AKI has a negative impact on the prognosis of affected patients and early risk stratification seems key to improve clinical outcomes. We analyzed metabolites of a conserved key inflammatory pathway (i.e. tryptophan degradation pathway) in serial urine samples of patients with AKI. One hundred twelve ICU patients with AKI were included in a prospective observational analysis. After exclusion criteria, 92 patients were eligible for analysis. Serial urine samples were collected and tryptophan levels including key tryptophan metabolites were measured using tandem mass spectrometry. Sixty-seven patients recovered in the first 7 days of AKI (early recovery, ER) whereas n = 25 had late-/non-recovery (LNR). Urinary concentrations of tryptophan, kynurenine, 3-OH anthranillic acid, serotonine, and kynurenine/tryptophan were significantly lower in LNR patients. In contrast, creatinine normalized excretion of kynurenic acid (KynA) was substantially increased in LNR patients (7.59 ± 6.81 vs. 3.19 ± 3.44 (ER) μmol/mmol, p <  0.005). High urinary KynA excretion was associated with higher RIFLE class, lo...Continue Reading

References

Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Apr 5, 2003·Kidney International·Raymond VanholderUNKNOWN European Uremic Toxin Work Group (EUTox)
Aug 18, 2004·Critical Care : the Official Journal of the Critical Care Forum·Rinaldo BellomoUNKNOWN Acute Dialysis Quality Initiative workgroup
Nov 9, 2004·Clinica Chimica Acta; International Journal of Clinical Chemistry·Renata HuskováPetr Schneiderka
Aug 18, 2005·JAMA : the Journal of the American Medical Association·Shigehiko UchinoUNKNOWN Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators
Feb 2, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Helmut Schiffl
Apr 15, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Helmut Schiffl, Rainald Fischer
Jul 18, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Belén PonteFernando Liaño
Jan 22, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jörg C SchefoldPetra Reinke
Dec 19, 2009·Journal of the American Society of Nephrology : JASN·Jean-Philippe Lafrance, Donald R Miller
Mar 27, 2010·The Annals of Thoracic Surgery·Madhav SwaminathanMark Stafford-Smith
Jun 18, 2010·Kidney International·Sushrut S WaikarJoseph V Bonventre
Mar 23, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·John W Pickering, Zoltán H Endre
Jun 4, 2011·Reproduction, Fertility, and Development·A E GroebnerS E Ulbrich
Jul 16, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Nattachai SrisawatJohn A Kellum
Aug 23, 2011·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·Jianxing ZhaoDingliang Zhu
Nov 19, 2011·Journal of the American Society of Nephrology : JASN·Azrina Md RalibZoltan H Endre
Nov 24, 2011·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Yuichi UwaiKikuo Iwamoto
Nov 6, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Neesh PannuUNKNOWN Alberta Kidney Disease Network
May 21, 2013·Journal of the American Society of Nephrology : JASN·Eugene P RheeRobert E Gerszten
Jan 5, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jennifer R CharltonMark D Okusa
Jan 8, 2014·Critical Care : the Official Journal of the Critical Care Forum·Stuart L GoldsteinJohn A Kellum
Jan 15, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ximing MoAiguo Tang
Oct 25, 2014·Nephron. Clinical Practice·Zoltán H Endre
Aug 31, 2016·Nature Reviews. Nephrology·Joerg C SchefoldStephan von Haehling
Feb 28, 2017·Nature Reviews. Nephrology·Lakhmir S ChawlaUNKNOWN Acute Disease Quality Initiative Workgroup 16.

❮ Previous
Next ❯

Citations

Jul 11, 2018·Current Heart Failure Reports·Agata Bielecka-DabrowaStephan von Haehling
May 7, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Jesse A DavidsonJelena Klawitter
Oct 8, 2021·Pharmacological Reports : PR·Izabela Zakrocka, Wojciech Załuska
Jan 11, 2022·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Alexandra FraniekTom D Blydt-Hansen

❮ Previous
Next ❯

Software Mentioned

SAS
GraphPad Prism
GraphPad

Related Concepts

Related Feeds

Related Papers

Journal of Critical Care
Sean M BagshawBeginning and Ending Supportive Therapy for the Kidney (B.E.S.T. Kidney) Investigators
Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
David Morgan
© 2022 Meta ULC. All rights reserved