RU-2861575-C1 - METHOD FOR DIAGNOSING ACUTE KIDNEY INJURY

Abstract

FIELD: medicine. SUBSTANCE: invention relates to resuscitation, urology, clinical laboratory diagnostics, and can be used for diagnosing acute kidney injury. Venous blood is collected. If the following clinical symptoms are present: urine output rate less than 0.5 ml/kg/h, swelling of the extremities and/or face, the concentration of cardiac fatty acid binding protein (cFABP) in the patient's venous blood is determined by an immunochromatographic test within the first 6 hours from the onset of said clinical symptoms. If the cFABP concentration is 10 ng/ml or more, and myocardial infarction, pulmonary embolism, paroxysm of atrial fibrillation of less than 48 hours, acute cerebrovascular accident, pulmonary oedema and cardiogenic shock are excluded, acute kidney injury is diagnosed. The immunochromatographic test 'Cardio cFABP' manufactured by SPC 'BioTest', Novosibirsk, with a visual assessment of the result by the presence of two coloured stripes, can be used to determine cFABP. EFFECT: possibility of fast, simple and accessible diagnosis of acute kidney injury using individual test systems without additional material and technical costs by determining the concentration of cFABP in the patient's blood. 2 cl, 3 ex

Inventors

• Bychkova Mariia Sergeevna
• Reznik Elena Vladimirovna

Dates

Publication Date

20260506

Application Date

20251117

Claims (2)

1. 1. A method for diagnosing acute kidney injury that includes collecting venous blood, characterized by the fact that in the presence of the following clinical symptoms: diuresis rate less than 0.5 ml/kg/h, edema of the extremities and/or face, the concentration of cardiac fatty acid binding protein (cFABP) in the patient's venous blood is determined by an immunochromatographic test during the first 6 hours from the onset of the said clinical symptoms; and if the cFABP concentration is 10 ng/ml or more and myocardial infarction, pulmonary embolism, paroxysmal atrial fibrillation for less than 48 hours, acute cerebrovascular accident, pulmonary edema and cardiogenic shock are excluded, acute kidney injury is diagnosed.
2. 2. The method according to paragraph 1, characterized in that the immunochromatographic test “CardioBSZHK” manufactured by NPO “BioTest”, Novosibirsk, is used, with a visual assessment of the result based on the presence of two colored stripes.

Description

The invention relates to the field of medicine, namely to resuscitation, diagnostics of emergency and urgent pathology of internal organs, and can be used to identify acute kidney injury (AKI). AKI is a pathological condition that develops as a result of direct acute exposure to renal and/or extrarenal damaging factors, lasting up to 7 days and characterized by the rapid (hours to days) development of signs of kidney damage or dysfunction of varying severity. AKI can be caused not only by renal factors but also by prerenal and postrenal factors (Scientific Society of Nephrologists of Russia: "Acute Kidney Injury (AKI)", Moscow, 2020). AKI is a syndrome of progressively worsening acute kidney injury, ranging from minimal changes in renal function to complete loss. AKI frequently develops in critically ill patients and, as an independent risk factor for death in such cases, is associated with a high mortality rate. Despite significant advances in medical science and practice, mortality has remained virtually unchanged over the past three decades, ranging from 28% to 90%, depending on the etiology and severity of AKI, the nature of the underlying and comorbid conditions, the patient's age, the type of intensive care unit, and a number of other factors (see Scientific Society of Nephrologists of Russia: "Acute Kidney Injury (AKI)", Moscow, 2020). Fatty acid binding protein (FABP) exists in several types (isoforms) that differ in their amino acid composition. Currently, nine different types of FABP have been identified, each specific to specific tissues. Cardiac FABP (cardiac FABP isoform, sFABP, H-FABR) is the dominant protein type found in the myocardium, skeletal muscle, and, to a lesser extent, in brown adipose tissue, distal tubules of the kidneys, the nervous system, and the mammary gland during lactation (Goel H. Heart-type fatty acid-binding protein: an overlooked cardiac biomarker / Goel H. //Annals of Medicine. 2020;52(8): P. 444-461). Previously, cardiac fatty acid binding protein (cardiac isoform of FABP, sFABP, H-FABR) was studied only as a marker of myocardial damage in urgent pathologies such as myocardial infarction (MI), pulmonary embolism (PE), and paroxysmal atrial fibrillation (AF). There are several published works on the study of another type of fatty acid binding protein, namely the renal isoform of fatty acid binding protein (L-FABR) in kidney damage (Galkovich K.R. Diagnostic value of determining fatty acid binding protein in the practice of a urologist and nephrologist // Far Eastern Medical Journal. 2020. No. 4 pp. 92-99). A method for diagnosing the risk of acute kidney injury (AKI) in acute pancreatitis in patients with no history of kidney disease or diabetes mellitus is also known (RU 2574716, C1). Color Doppler imaging is used to examine the renal vessels. The maximum blood flow velocity in the interlobar veins of the kidneys is determined, and values greater than 0.14 m/s indicate the risk of acute kidney injury (AKI). This method improves the accuracy of diagnosing acute kidney injury (AKI) in various forms of acute pancreatitis by assessing the functional state of the kidneys. A disadvantage of this method is that color Doppler ultrasound is not always possible upon admission due to time constraints and the need for urgent treatment, which complicates the early diagnosis of acute pancreatitis. The authors' exclusion criteria include the presence of diabetes mellitus, making the method inapplicable to a large cohort of patients with acute pancreatitis. A method for the early diagnosis of AKI is known (RU 2702023, C1) (prototype). At the preoperative stage, the following parameters are determined in venous blood: the concentration of cystatin C - symbol Z, intraoperatively the duration of warm ischemia of the kidney (WRK) is recorded - symbol Y. 16 hours after the operation, the concentrations of cystatin C, the renal isoform of fatty acids (L-FABR) and lipocaine associated with gelatinase (NGAL) in venous blood are determined, and the patient's diuresis rate is also assessed - symbol X. Then, for each of the parameters (X, Y, Z), a conditional numerical value in points from 0 to 1 is calculated. AKI is diagnosed with a value of 2.8 < α ≤ 3. The method ensures early diagnosis of AKI in patients after partial nephrectomy under WRK conditions (before the onset of an increase in the creatinine level) due to the duration of WRK. A disadvantage of this method is that the assessment of the development of acute kidney injury in patients undergoing partial nephrectomy is performed under the conditions of the initial urine flow monitoring (IFU). Since the duration of IFU is one of the criteria, this method cannot be used for other types of interventions. Urine output is calculated every 60 minutes for 24-48 hours, which often requires bladder catheterization. This is time-consuming, labor-intensive, and can lead to infectious complications. Determination of gelatinase-associated lipocaine