NEPHROCHECK^®

In intensive care units, critically ill patients are commonly exposed to nephrotoxic drugs (such as antibiotics, vasopressors, diuretics and radiocontrast agents) that help preserve their key vital functions but can cause serious complications, up to permanent kidney loss. Acute Kidney Injury (AKI) occurs in more than 50% of patients on day 1 of their stay¹. It is associated with a 10-fold increase in hospital mortality rates², while hospital costs, length of stay and 30-day re-admissions can become at least twice as severe^3,4.

AKI is a silent killer, with no immediate specific signs or symptoms. Diagnosis with commonly used kidney function tests often comes too late⁶. The good news is that both acute and long-term kidney damage can be avoided if the risk is identified and managed early.⁵ What if you had an opportunity to intervene proactively and preserve your patient’s renal function?

NEPHROCHECK^® is an innovative test that detects kidney stress prior to actual damage, when intervention can still make a difference. It is intended to be used as a risk assessment test, in conjunction with clinical evaluation, to aid in identifying patients at risk for developing moderate or severe AKI within 12 hours.

With this early warning, intensivists may either rule out patient with confidence, or implement a series of nephroprotective measures to significantly improve patient outcomes and reduce costs^7,8, avoiding the need for dialysis and other comorbidities that typically result from AKI.

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The kidneys’ alarm system

The NEPHROCHECK^® test detects TIMP-2 (tissue inhibitor of metalloproteinases-2) and IGFBP-7 (insulin-like growth factor-binding protein 7).

These novel urinary biomarkers are produced by stressed kidney cells as an early warning signal, before the onset of acute kidney injury.

Specific to kidney stress, they are not affected by any of the usual co-morbidities (such as sepsis, trauma, chronic kidney disease or cancer).⁹

Testing strategy

The NEPHROCHECK^® test provides a single quantitative result, the AKIRISK^™ score.

Want to know more about how NEPHROCHECK^® may help you reach your ultimate goal, to save patients, while limiting potential additional harm to their kidneys?

 

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References

1. Hoste EAJ, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Medecine 2015;41:1411–1423.

2. Hobson C, et al. Cost and mortality associated with postoperative acute kidney injury. Ann Surg. 2014;00:1-8.)

3. Dasta JF, et al. Costs and outcomes of acute kidney injury (AKI) following cardiac surgery. Nephrol Dial Transplant. 2008;23(6):1970-1974.

4. Brown JR, et al, for the Northern New England, Cardiovascular Disease Study Group. Impact of perioperative acute kidney injury as a severity index for thirty-day readmission after cardiac surgery. Ann Thorac Surg. 2014;97(1):111-117.

5. Mehta RL, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet. 2015.

6. McCullough PA, et al. Diagnosis of acute kidney injury using functional and injury biomarkers: workgroup statements from the tenth Acute Dialysis Quality Initiative Consensus Conference. Contrib Nephrol. 2013;182:13-29.

7. Göcze I, et al. Biomarker-guided intervention to prevent acute kidney injury after major surgery: the prospective randomized BigpAK Study. Ann Surg. Published online August 2017.

8. Meersch M, et al. Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. Intensive Care Med. 2017 Jan 21.

9. Kashani K et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Critical Care 2013 Feb 6;17(1):R25.

10. KDIGO Clinical Practice Guideline for Acute Kidney Injury, http://www.kidney-international.org