Comparative performance of urinary biomarkers for vancomycin induced kidney injury according to timeline of injury.

TitleComparative performance of urinary biomarkers for vancomycin induced kidney injury according to timeline of injury.
Publication TypeJournal Article
Year of Publication2019
AuthorsPais GM, Avedissian SN, J O'Donnell N, Rhodes NJ, Lodise TP, Prozialeck WC, Lamar PC, Cluff C, Gulati A, Fitzgerald JC, Downes KJ, Zuppa AF, Scheetz MH
JournalAntimicrob Agents Chemother
Date Published2019 Apr 15
ISSN1098-6596
Abstract

Urinary biomarkers are superior to serum creatinine for defining onset and extent of kidney injury. This study classifies the temporal predictive ability of biomarkers for vancomycin-induced kidney injury (VIKI) as defined by histopathologic damage.: Male Sprague-Dawley rats (n=125) were randomized to receive 150 to 400 mg/kg/day vancomycin via once or twice daily intraperitoneal injection over 1, 3, or 6 days. Urine was collected once during the 24 hours prior to euthanasia or twice for rats treated for 6 days. Receiver operating characteristic curves (ROC) were employed to assess urinary biomarker performance of kidney injury molecule 1 (KIM-1), clusterin, osteopontin (OPN), cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL) to predict histopathologic defined VIKI (using a national standard pathologic assessment scheme from hematoxylin and eosin stained kidneys). Urinary KIM-1, clusterin, and OPN outperformed cystatin C and NGAL according to sensitivity and specificity. For the earliest injury, urinary KIM-1 (AUC 0.662, p<0.001) and clusterin (AUC 0.706, p<0.001) were most sensitive to predicting even low-level histopathologic damage at 24 h when compared to NGAL. KIM-1 and clusterin are earliest and most sensitive predictors of VIKI. As injury progresses, KIM-1, clusterin and OPN define the extent of damage best.

DOI10.1128/AAC.00079-19
Alternate JournalAntimicrob. Agents Chemother.
PubMed ID30988153
Grant ListK23 HD091365 / HD / NICHD NIH HHS / United States