Observational studyBMC nephrology2018
Increased urinary excretion of kynurenic acid is associated with non-recovery from acute kidney injury in critically ill patients.
Observational study in BMC nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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Who cites it
22 citing papers in PubMed, 30 citations in OpenAlex.
- Discovery urinary metabolomics of preterm neonatal acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2026Observational
- Integrative Pharmacokinetic and Metabolomic Profiling ofInternational journal of molecular sciences · 2026Article
- Artesunate alleviates cisplatin-induced nephrotoxicity by regulating tryptophan metabolism and inhibiting ferroptosis.Frontiers in pharmacology · 2026Article
- Pediatric acute kidney injury is associated with impairment in nicotinamide adenine dinucleotide (NAD+) metabolism.Pediatric nephrology (Berlin, Germany) · 2025Observational
- Current role of biomarkers in the initiation and weaning of kidney replacement therapy in acute kidney injury.World journal of nephrology · 2025Review
- Targeted Analysis of Serum and Urinary Metabolites for Early Chronic Kidney Disease.International journal of molecular sciences · 2025Article
- Acute kidney injury through a metabolic lens: pathological reprogramming mechanisms and clinical translation potential.Frontiers in physiology · 2025Review
- Derangement in Nicotinamide Adenine Dinucleotide Metabolism is Observed During Acute Kidney Injury Among Male Agricultural Workers at Risk for Mesoamerican Nephropathy.Kidney international reports · 2024Article
- Altered kynurenine pathway metabolism and association with disease activity in patients with systemic lupus.Amino acids · 2023Article
- Urinary cell cycle biomarkers for the prediction of renal non-recovery in patients with septic acute kidney injury: a prospective study.Clinical and experimental nephrology · 2023Observational
- Interleukin-6 promotes skeletal muscle catabolism by activating tryptophan-indoleamine 2,3-dioxygenase 1-kynurenine pathway during intra-abdominal sepsis.Journal of cachexia, sarcopenia and muscle · 2023Article
- Identification of Biomarkers for the Diagnosis of Sepsis-Associated Acute Kidney Injury and Prediction of Renal Recovery in the Intensive Care Unit.Yonsei medical journal · 2023Article
- Article
- Urinary metabolomics to develop predictors for pediatric acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2022Article
- Metabolomic profiling demonstrates evidence for kidney and urine metabolic dysregulation in a piglet model of cardiac surgery-induced acute kidney injury.American journal of physiology. Renal physiology · 2022Article
- Kynurenine pathway in kidney diseases.Pharmacological reports : PR · 2022Review
- Article
- Serum metabolic profile of postoperative acute kidney injury following infant cardiac surgery with cardiopulmonary bypass.Pediatric nephrology (Berlin, Germany) · 2021Article
- Multi-Solvent Extraction Procedure for the Pioneer Fecal Metabolomic Analysis-Identification of Potential Biomarkers in Stable Kidney Transplant Patients.Diagnostics (Basel, Switzerland) · 2021Article
- Fecal Metabolomics Reveals Distinct Profiles of Kidney Transplant Recipients and Healthy Controls.Diagnostics (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury (AKI) is often observed in critically ill patients and is associated with high morbidity and mortality. Non-recovery from AKI has a negative impact on the prognosis of affected patients and early risk stratification seems key to improve clinical outcomes. We analyzed metabolites of a conserved key inflammatory pathway (i.e. tryptophan degradation pathway) in serial urine samples of patients with AKI.
methodsOne hundred twelve ICU patients with AKI were included in a prospective observational analysis. After exclusion criteria, 92 patients were eligible for analysis. Serial urine samples were collected and tryptophan levels including key tryptophan metabolites were measured using tandem mass spectrometry.
resultsSixty-seven patients recovered in the first 7 days of AKI (early recovery, ER) whereas n = 25 had late-/non-recovery (LNR). Urinary concentrations of tryptophan, kynurenine, 3-OH anthranillic acid, serotonine, and kynurenine/tryptophan were significantly lower in LNR patients. In contrast, creatinine normalized excretion of kynurenic acid (KynA) was substantially increased in LNR patients (7.59 ± 6.81 vs. 3.19 ± 3.44 (ER) μmol/mmol, p < 0.005). High urinary KynA excretion was associated with higher RIFLE class, longer AKI duration, increased need for RRT, and 30-day mortality. Logistic regression revealed KynA as the single most important predictor of renal recovery on days 1 and 2 of AKI.
conclusionsIncreased urinary levels of kynurenic acid, a key inflammatory metabolite of the tryprophan degradation pathway, are associated with adverse renal and clinical outcomes in critically ill patients with AKI. Urinary KynA may serve as an early risk stratificator in respective patients with AKI.
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