Using 1 h-nmr urea-based metabonomics identification of new biomarkers of acute kidney injury

"In conclusion, this study shows that NMR spectroscopy in the diagnosis of pediatric patients with AKI has higher accuracy."

Nuclear magnetic resonance spectroscopy (NMR) can simultaneously measure the samples of all the small molecules in for metabonomics analysis provides a very good tool.It has been widely applied in disease biomarker identification, to guide diagnosis and treatment decisions.

Researchers in several metabolomics study found a variety of biomarkers of acute kidney injury (AKI).Unfortunately, in clinical practice, is not a sufficient specificity, damage to the kidney and metabonomics analysis was carried out on the children's AKI few clinical studies.

AKI is a severe, acute kidney function decline, will interfere with the normal blood steady state.Therefore, the waste and the increase of the content of potassium in the blood can cause nausea and vomiting, muscle weakness, and cardiac arrhythmias.It is a common complication of critically ill patients can severely hinder the recovery.Children and neonatal prognosis in patients with poor in particular.

It is important to diagnosis of AKI quickly, in order to control the effect, and reduce the incidence of a disease.Currently the gold standard in the diagnosis of AKI, namely the measurement of serum creatinine and urine output, only can provide indirect indicator of glomerular filtration rate reduce.Therefore, before the problem becomes apparent delay.In addition, failure to provide information about the cause of renal damage potential.

In a recent study in pediatrics, researchers have dealt with in the early diagnosis of AKI have been unsatisfied demand.In order to assess whether neonatal and pediatric patients with AKI has a unique set of fingerprints, urine metabolism researchers choose equipped with double resonance 5 - mm BBI probe brook 600 MHz Avance II mass spectrometer, the confirmed AKI neonatal and pediatric patients and healthy controls a urine sample for 1 h NMR analysis.

The analysis results show that there are four groups of metabolites can be used as diagnostic indicators of AKI.1 h NMR spectra showed that compared with patients without AKI, citrate were significantly reduced in patients with AKI urine, leucine and valine levels.The researchers found that the cause of different among different subtypes of AKI metabolites spectrum is not the same.

In some animal studies have been identified as potential biomarkers of AKI metabolites (hippuric acid salt, indole sulfate, creatinine) in healthy controls, there is no difference between patients with AKI.In addition, compared with the previous reports, the metabolites of neonatal and pediatric patients with similar spectral change.

The latest data for the development of a new technology of early identification of patients with AKI provides a promising leads.Although need to be further validated in larger studies, but we hope that we have observed the metabolites of spectrum difference eventually can be used to improve the prognosis of patients with AKI.In addition, AKI subtype metabolomic differentiation potential may enable the treatment to adjust for differences in the underlying cause of AKI.

References:

• Muhle - Goll C, et al. Int. J. Mol. Sci., 2020;Moreover, 87. https://www.mdpi.com/1422-0067/21/4/1187