Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting

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...

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Detalles Bibliográficos
Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p18792
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=18792
http://ddd.uab.cat/record/310400
Access Level:acceso abierto
Palabra clave:Biomarker testing experience
C-C motif chemokine ligand 14 (CCL14)
consensus
critical care nephrology
persistent acute kidney injury
Descripción
Sumario: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.