Urine Test Predicts Acute Kidney Injury Prognosis

The severity of the acute kidney injury (AKI) condition can range from minor loss of kidney function to complete kidney failure, and 50% to 60% of people who develop the condition die as a result and this figure has not changed in the last four decades.

In AKI the kidneys suddenly stop working properly and it often occurs as a result of something which gives the kidneys a “shock” such as an operation, an infection or severe illness, but it is not caused as a result of a physical blow to the body. AKI can become a life-threatening problem within hours, meaning that early recognition and prompt treatment are crucial.

Scientists at Cardiff University (UK) are investigating whether the urine of patients with AKI could give previously hidden clues to how their condition will progress, and show how likely they are to recover from their illness. The team will collect urine samples from patients with AKI and evaluate the ability of micro ribonucleic acid (RNA) levels to predict what subsequently happens to that individual. Different levels of microRNAs could indicate how likely a patient is to recover from the condition, or how likely it is that their condition will deteriorate. This newly discovered group of microRNA molecules could help predict the progression of AKI as previous data has shown that the levels of these molecules change in AKI, and the team will investigate this further.

Existing tests for AKI include monitoring a patient's urine output, and measuring the amount of toxins building up in their blood stream as a result of kidney failure. Both show that the kidneys are not working properly, but these measures can take hours to change and may not show a problem immediately. AKI affects one in six people who are admitted to hospital, causing around 40,000 deaths every year in the UK and an earlier report suggests that up to 30% of cases may be preventable. Timothy Bowen, PhD, and his team at Cardiff University have received funding of almost GBP 200,000 from Kidney Research UK (Peterborough, UK). They hope their work will lead to the development of new tests to show the status of AKI in patients, so doctors can monitor them accordingly.

Dr. Bowen, said, “Even though AKI is preventable, it has a very high mortality rate. We therefore wish to find ways to identify which AKI patients are most at risk of progressing to irreversible kidney failure. This will allow doctors to monitor these patients closely, and treat them sooner, to prevent this happening. We're hopeful that, in time, this work will help us to develop new methods to screen for AKI. Ideally, we'd like to produce a traffic light system enabling doctors to say 'this patient is at increased risk of kidney failure and will require closer monitoring.”

Related Links:
Cardiff University 
Kidney Research UK