title: Hsp72 is a novel biomarker to predict acute kidney injury in critically ill patients.
abstract: OBJECTIVE
  Acute kidney injury (AKI) complicates the course of disease in critically ill patients. Efforts to change its clinical course have failed because of the fail in the early detection. This study was designed to assess whether heat shock protein (Hsp72) is an early and sensitive biomarker of acute kidney injury (AKI) compared with kidney injury molecule (Kim-1), neutrophil gelatinase-associated lipocalin (NGAL), and interleukin-18 (IL-18) biomarkers.
  
  
  METHODS
  A total of 56 critically ill patients fulfilled the inclusion criteria. From these patients, 17 developed AKI and 20 were selected as controls. In AKI patients, Kim-1, IL-18, NGAL, and Hsp72 were measured from 3 days before and until 2 days after the AKI diagnosis and in no-AKI patients at 1, 5 and 10 days after admission. Biomarker sensitivity and specificity were determined. To validate the results obtained with ROC curves for Hsp72, a new set of critically ill patients was included, 10 with AKI and 12 with no-AKI patients.
  
  
  RESULTS
  Urinary Hsp72 levels rose since 3 days before the AKI diagnosis in critically ill patients; this early increase was not seen with any other tested biomarkers. Kim-1, IL-18, NGAL, and Hsp72 significantly increased from 2 days before AKI and remained elevated during the AKI diagnosis. The best sensitivity/specificity was observed in Kim-1 and Hsp72: 83/95% and 100/90%, respectively, whereas 1 day before the AKI diagnosis, the values were 100/100% and 100/90%, respectively. The sensibility, specificity and accuracy in the validation test for Hsp72 were 100%, 83.3% and 90.9%, respectively.
  
  
  CONCLUSIONS
  The biomarker Hsp72 is enough sensitive and specific to predict AKI in critically ill patients up to 3 days before the diagnosis.
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Morales-Buenrostro
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: Omar I
authors.initials: OI
authors.lastname: Salas-Nolasco
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México; Unidad de Fisiología Molecular, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México City, México.
authors.forename: Jonatan
authors.initials: J
authors.lastname: Barrera-Chimal
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Casas-Aparicio
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.
authors.forename: Sergio
authors.initials: S
authors.lastname: Irizar-Santana
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México; Unidad de Fisiología Molecular, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México City, México.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Pérez-Villalva
authors.affiliation: Department of Nephrology Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México; Unidad de Fisiología Molecular, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México City, México.
authors.forename: Norma A
authors.initials: NA
authors.lastname: Bobadilla
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis*; D000209:Acute-Phase Proteins / Q000378:metabolism / Q000652:urine; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000378:metabolism / Q000652:urine; D016638:Critical Illness; D005260:Female; D055551:HSP27 Heat-Shock Proteins / Q000378:metabolism / Q000652:urine*; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007362:Intensive Care Units; D020382:Interleukin-18 / Q000378:metabolism / Q000652:urine; D000071068:Lipocalin-2; D054834:Lipocalins / Q000378:metabolism / Q000652:urine; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism / Q000652:urine; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000378:metabolism / Q000652:urine; D012372:ROC Curve; D011991:Receptors, Virus / Q000378:metabolism
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C491143:HAVCR1 protein, human; D055551:HSP27 Heat-Shock Proteins; D000072596:Hepatitis A Virus Cellular Receptor 1; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus