{"id":28472,"date":"2025-09-22T04:49:00","date_gmt":"2025-09-21T20:49:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28472"},"modified":"2025-09-22T05:40:11","modified_gmt":"2025-09-21T21:40:11","slug":"icu-management-practice-%e6%80%a5%e6%80%a7%e8%82%be%e6%8d%9f%e4%bc%a4%e7%9a%84%e7%94%9f%e7%89%a9%e6%a0%87%e5%bf%97%e7%89%a9%ef%bc%9amarkisio%e7%a0%94%e7%a9%b6","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28472","title":{"rendered":"[ICU Management &#038; Practice]: \u6025\u6027\u80be\u635f\u4f24\u7684\u751f\u7269\u6807\u5fd7\u7269\uff1aMARKISIO\u7814\u7a76"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Biomarkers in Acute Kidney Injury: MARKISIO Study<\/h1>\n\n\n\n<ul>\n<li>In&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\">ICU<\/a><\/li>\n\n\n\n<li>Thu, 22 May 2025<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/c_thumb,f_auto,fl_lossy,q_90\/v1747916290\/cw\/00130140_cw_image_wi_72b59803e8d33fad695de0205cf7105c.webp\" alt=\"\"\/><\/figure>\n\n\n\n<p>Acute Kidney Injury (AKI) in critically ill patients carries high morbidity and mortality, especially when renal replacement therapy (RRT) is needed. Despite interest in using biomarkers to predict the need for RRT, reliable tools remain lacking. Previous studies, including the RUBY trial, explored biomarkers for persistent AKI but not specifically for predicting RRT necessity. Most existing research also failed to clearly define RRT indications, often reflecting variable clinical judgment rather than objective need. However, four recent large RCTs (AKIKI, IDEAL-ICU, STARRT-AKI, AKIKI2) have clarified RRT initiation criteria.&nbsp;<\/p>\n\n\n\n<p>Building on this, a recent study uses biomarker data from the AKIKI2 biobank to evaluate whether biomarkers can predict when RRT criteria are met. This could enhance early intervention and personalised care in severe AKI. The MARKISIO study assessed whether a panel of routine and novel biomarkers could predict the need for renal replacement therapy (RRT) within 72 hours after the onset of severe&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\/News\/ventilation-induced-aki-in-acute-respiratory-failure\" target=\"_blank\" rel=\"noreferrer noopener\">AKI<\/a>&nbsp;in critically ill patients.&nbsp;<\/p>\n\n\n\n<p>This ancillary study of the AKIKI2 trial included patients with stage 3 severe AKI who were on invasive mechanical ventilation and\/or vasopressors. Blood and urine samples were collected within 12 hours of AKI onset. The primary outcome was the onset of clearly defined RRT initiation criteria within 72 hours. The study analysed both routine serum biomarkers (pH, potassium, creatinine) and novel urinary and serum biomarkers, including CCL14, KIM1, nicotinamide and its metabolites, cDPP3, and plasma proenkephalin A 119-159.<\/p>\n\n\n\n<p>Out of 256 patients, 101 (39%) either met RRT initiation criteria or died within 72 hours. None of the tested biomarkers showed satisfactory predictive performance for this outcome. Additionally, no novel biomarker was significantly linked to major adverse kidney events at 60 days (MAKE60). Multivariable analysis identified only SAPS III score and serum potassium level at day 0 as significantly associated with MAKE60.<\/p>\n\n\n\n<p>Among 256 patients, 39% either met clear RRT criteria or died within 72 hours, and 56.2% experienced MAKE60. However, none of the biomarkers achieved satisfactory predictive performance for either outcome.<\/p>\n\n\n\n<p>Despite selecting biomarkers relevant to various AKI mechanisms\u2014such as KIM1 (kidney injury and repair), nicotinamide (metabolic recovery), cDPP3 (renal hemodynamics), PenKid (early AKI detection), and CCL14 (persistent AKI)\u2014none provided predictive value for RRT need or MAKE60.&nbsp;<\/p>\n\n\n\n<p>This ancillary study of the AKIKI2 trial concluded that, when using well-defined RRT initiation criteria, biomarkers do not appear effective for guiding RRT initiation or predicting renal outcomes in patients with severe AKI who may require RRT.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-025-05439-y\" target=\"_blank\" rel=\"noreferrer noopener\">Critical Care<\/a><\/p>\n\n\n\n<p>Image Credit: iStock<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">References:<\/h4>\n\n\n\n<p>Cha\u00efbi K, Picod A, Boubaya M et al. (2025)&nbsp;<a href=\"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-025-05439-y\" target=\"_blank\" rel=\"noreferrer noopener\">Biomarkers in acute kidney injury settings to predict interventions and outcomes: the MARKISIO study.<\/a>&nbsp;Crit Care. 29, 204.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Biomarkers in Acute Kidney Injury: MARKISIO Study Acute [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28472"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28472"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28472\/revisions"}],"predecessor-version":[{"id":28473,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28472\/revisions\/28473"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28472"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28472"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28472"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}