Development of a MALDI MS-based platform for early detection of acute kidney injury.
Septic acute kidney injury (AKI) is associated with poor outcome. This can partly be attributed to delayed diagnosis and incomplete understanding of the underlying pathophysiology. Our aim was to develop an early predictive test for AKI based on the analysis of urinary peptide biomarkers by MALDI-MS.



Urine samples from 95 patients with sepsis were analyzed by MALDI-MS. Marker search and multimarker model establishment were performed using the peptide profiles from 17 patients with existing or within the next 5 days developing AKI and 17 with no change in renal function. Replicates of urine sample pools from the AKI and non-AKI patient groups and normal controls were also included to select the analytically most robust AKI markers.



Thirty-nine urinary peptides were selected by cross-validated variable selection to generate a support vector machine multidimensional AKI classifier. Prognostic performance of the AKI classifier on an independent validation set including the remaining 61 patients of the study population (17 controls and 44 cases) was good with an area under the receiver operating characteristics curve of 0.82 and a sensitivity and specificity of 86% and 76%, respectively.



A urinary peptide marker model detects onset of AKI with acceptable accuracy in septic patients. Such a platform can eventually be transferred to the clinic as fast MALDI-MS test format.
Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
Emma
E
Carrick
Renal Division, Ghent University Hospital, Belgium.
Jill
J
Vanmassenhove
Renal Division, Ghent University Hospital, Belgium.
Griet
G
Glorieux
Mosaiques Diagnostics GmbH, Hannover, Germany.
Jochen
J
Metzger
Mosaiques Diagnostics GmbH, Hannover, Germany.
Mohammed
M
Dakna
Mosaiques Diagnostics GmbH, Hannover, Germany.|Charite-Universitätsmedizin Berlin, Berlin, Germany.
Martin
M
Pejchinovski
RWTH Aachen, Institute of Molecular Cardiovascular Research, Aachen, Germany.
Vera
V
Jankowski
Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
Bahareh
B
Mansoorian
Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
Holger
H
Husi
Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
William
W
Mullen
Institute of Cardiovascular and Medical Sciences, Glasgow, UK.|Mosaiques Diagnostics GmbH, Hannover, Germany.
Harald
H
Mischak
Renal Division, Ghent University Hospital, Belgium.
Raymond
R
Vanholder
Renal Division, Ghent University Hospital, Belgium.
Wim
W
Van Biesen
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000595:Amino Acid Sequence; D015415:Biomarkers / Q000737:chemistry / Q000652:urine; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000737:chemistry / Q000652:urine; D012372:ROC Curve; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D055815:Young Adult
D015415:Biomarkers; D010455:Peptides
Acute kidney injury; MALDI-MS; Peptide marker model