Methods and compositions for diagnosis and prognosis of renal injury and renal failure
The present invention relates to methods and compositions for monitoring, diagnosis, prognosis, and determination of treatment regimens in subjects suffering from or suspected of having a renal injury. In particular, the invention relates to using assays that detect one or more of Metalloproteinase inhibitor 1, Metalloproteinase inhibitor 2, Metalloproteinase inhibitor 4, C—C motif chemokine 15, C—C motif chemokine 18, C—C motif chemokine 23, and/or, C—C motif chemokine 24 as diagnostic and prognostic biomarker assays in renal injuries.
1. A method of treating a subject having acute kidney injury, the method comprising:
(a) detecting a level of Metalloproteinase inhibitor 2 in a body fluid sample obtained from the subject;
(b) determining the subject is at an increased risk of persistent acute kidney injury when the detected level of Metalloproteinase inhibitor 2 is above a predetermined threshold level of Metalloproteinase inhibitor 2, wherein persistent acute kidney injury is a minimum RIFLE stage of RIFLE stage R during a period no less than 24 hours, the period beginning within 7 days after sample collection; and
(c) treating the subject based on the subject's increased risk of persistent acute kidney injury for persistent acute kidney injury, wherein the treatment comprises renal replacement therapy, withdrawing delivery of compounds that are known to be damaging to the kidney, delaying procedures that are known to be damaging to the kidney, or modifying diuretic administration.
2. The method of claim 1 , wherein persistent acute kidney injury is a minimum RIFLE stage of RIFLE stage F during the period.
3. The method of claim 1 , wherein the subject has RIFLE stage R acute kidney injury.
4. The method of claim 1 , wherein the subject has RIFLE stage I acute kidney injury.
5. The method of claim 1 , wherein the subject has RIFLE stage F acute kidney injury.
6. The method of claim 1 , wherein the period is no less than 48 hours.
7. The method of claim 1 , wherein the period is no less than 72 hours.
8. The method of claim 1 , wherein the sample is a urine sample.
9. The method of claim 1 , wherein persistent acute kidney injury is a minimum RIFLE stage of RIFLE stage I during the period.
10. The method of claim 9 , wherein the subject has RIFLE stage I or F acute kidney injury.
11. The method of claim 9 , wherein the period is no less than 48 hours.
12. The method of claim 9 , wherein the period is no less than 72 hours.
13. The method of claim 9 , wherein the period starts within 48 hours after sample collection.
14. The method of claim 9 , wherein the period starts within 72 hours after sample collection.
15. The method of claim 9 , wherein the period starts within 96 hours after sample collection.
16. The method of claim 2 , wherein the subject has RIFLE stage I or F acute kidney injury.
17. The method of claim 2 , wherein the period is no less than 48 hours.
18. The method of claim 2 , wherein the period is no less than 72 hours.
19. The method of claim 2 , wherein the period starts within 72 hours after sample collection.
20. The method of claim 2 , wherein the period starts within 96 hours after sample collection.