- Biological markers for kidney injury and renal function in the intensive care unit
- Award date
- 24 September 2014
- Number of pages
- Document type
- PhD thesis
- Faculty of Medicine (AMC-UvA)
The purpose of the investigations described in this thesis was to seek for answers to two relevant questions in ICUs in resource-rich settings, i.e., can new biological markers play a role in early recognition of AKI, and can new biological markers predict recovery of renal function in patients who receive CVVH? A second aim was to answer a relevant question in ICUs in resource-poor settings, i.e., can novel biological markers predict development of AKI and need for RRT in patients with severe P. falciparum malaria?
Both CyC and NGAL have been suggested promising endogenous biological markers for AKI in ICU patients. Results from the prospective observational SCARF study suggests that neither CyC nor NGAL are useful biological markers for AKI and need for RRT. The patient population in SCARF is rather heterogeneous. We believe this cohort better reflects the patient populations seen in the ICU in whom the abovementioned questions are relevant. Based on the findings in the SCARF study and its secondary analyses we conclude CyC and NGAL cannot serve as biological markers in clinical practice.
As suPAR has a good prognostic value in patients with the systemic inflammatory response syndrome, sepsis or bacteremia, we speculated suPAR to have pathogenetic role in patients with severe P. falciparum. The investigation described in this thesis suggests this to be true. But a prognostic value for suPAR with AKI in this specific patient group was not confirmed.
- Research conducted at: Universiteit van Amsterdam
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