Acute Kidney Injury in the Emergency Department: Role of Proenkephalin A 119-159

Abstract

In the emergency department (ED) and critically ill patients in general, acute kidney injury (AKI) is a common complication, and obtaining timely information about kidney function is crucial for initiating protective measures as early as possible. Creatinine-based estimations of the glomerular filtration rate are currently the standard of care, but they are imprecise, prone to errors, and have significant time delays in the identification of reduced kidney function and kidney damage. Emerging research indicates that proenkephalin A 119-159 (penKid) may overcome these drawbacks by indirectly assessing the hormone enkephalin, which stimulates kidney function. This approach offers a more precise evaluation of the kidney. As a novel biomarker for detecting AKI, penKid can be measured immediately upon a patient's arrival at the ED or intensive care unit (ICU), allowing for the early prediction of declining renal function up to 48 h ahead of current diagnostic practices. In summary, penKid offers rapid access to vital information about kidney function for physicians in the ED and ICU. This information complements current diagnostic tools and enables early assessment of renal function. Consequently, penKid can assist clinicians in various clinical scenarios, such as guiding the administration of nephrotoxic drugs or aiding decisions regarding the discontinuation of renal replacement therapy.