Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting
Por:
Koyner, JL, Arndt, C, de Irujo, JBM, Coelho, S, de la Peña, MGM, di Girolamo, L, Joannidis, M, Jorge-Monjas, P, Koch, C, Lobaz, S, Meyer, A, Ostermann, M, Pertica, N, Prowle, JR, Silversides, J, Zarbock, A, Echeverri, J, Harenski, K, Forni, LG
Publicada:
31 dic 2024
Resumen:
Background: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions. Methods: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as >= 80% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale). Results: Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan (p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences. Conclusion: Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.
Filiaciones:
Koyner, JL:
Univ Chicago, Dept Med, Sect Nephrol, 5841 South Maryland Ave Suite S-512,MC 5100, Chicago, IL 60637 USA
Arndt, C:
Philipps Univ Marburg, Anesthesiol & Intens Care Med, Fachbereich Med, Marburg, Germany
de Irujo, JBM:
Hosp Santa Creu & Sant Pau, Dept Crit Care Med, Barcelona, Spain
Coelho, S:
Hosp Fernando Fonseca EPE, Intens Care Dept, Amadora, Portugal
de la Peña, MGM:
Navarra Univ Hosp, Dept Intens Care, Pamplona, Spain
di Girolamo, L:
IRCCS Policlin San Donato, Dept Anesthesia Crit Care & Emergency, San Donato Milanese, Italy
Joannidis, M:
Med Univ Innsbruck, Dept Internal Med, Div Intens Care & Emergency Med, Innsbruck, Austria
Jorge-Monjas, P:
Clin Univ Hosp Valladolid, Anesthesiol & Crit Care Dept, Valladolid, Spain
Koch, C:
Justus Liebig Univ Giessen, Dept Anesthesiol Intens Care Med & Pain Therapy, Giessen, Germany
Lobaz, S:
Barnsley Hosp NHS Fdn Trust, Anaesthet & Intens Care, Barnsley, England
Meyer, A:
Univ Hosp Strasbourg, Physiol & Funct Explorat Serv, Strasbourg, France
Ostermann, M:
Kings Coll London, Guys & St Thomas Hosp, Dept Crit Care & Nephrol, London, England
Pertica, N:
Univ Hosp Verona, Dept Biomed & Surg Sci, Div Nephrol, Verona, Italy
Prowle, JR:
Queen Mary Univ London, William Harvey Res Inst, Crit Care & Perioperat Med Res Grp, London, England
Silversides, J:
Queens Univ, Wellcome Wolfson Inst Expt Med, Belfast, North Ireland
Zarbock, A:
Univ Hosp Munster, Dept Anesthesiol Intens Care & Pain Med, Munster, Germany
Echeverri, J:
Baxter Healthcare Corp, Deerfield, IL USA
Harenski, K:
Baxter Deutschland GmbH, Unterschleissheim, Germany
Forni, LG:
Royal Surrey Hosp, Crit Care Unit, Guildford, Surrey, England
Univ Surrey, Sch Med, Guildford, Surrey, England
Green Published, gold
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