ArticlePediatric nephrology (Berlin, Germany)2023
Acute kidney injury biomarker olfactomedin 4 predicts furosemide responsiveness.
Article in Pediatric nephrology (Berlin, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Novel biomarkers for acute kidney injury in high-risk pediatric populations: a systematic review.Renal failure · 2026Pooled it
- Furosemide Stress Test Use in Children at Risk for Acute Kidney Injury.Kidney international reports · 2025Article
- Urine Olfactomedin 4 Predicts Furosemide Response and Kidney Replacement Therapy in Critically Ill Children.Critical care explorations · 2025Observational
- Olfactomedin-4 elevation in pediatric acute respiratory distress syndrome.American journal of physiology. Lung cellular and molecular physiology · 2025Article
- The promise of biomarkers: precision medicine will pave a roadmap for pediatric acute kidney injury management in critically ill children.Intensive care medicine. Paediatric and neonatal · 2025Review
- Furosemide stress test to predict acute kidney injury progression in critically ill children.Pediatric nephrology (Berlin, Germany) · 2025Article
- Prediction of cardiac surgery associated acute kidney injury using response to loop diuretic and urine neutrophil gelatinase associated lipocalin.Pediatric nephrology (Berlin, Germany) · 2024Observational
- Biomarkers in pursuit of precision medicine for acute kidney injury: hard to get rid of customs.Kidney research and clinical practice · 2024Article
- A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children: a report from the 26th Acute Disease Quality Initiative (ADQI) conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Precision management of acute kidney injury in the intensive care unit: current state of the art.Intensive care medicine · 2023Review
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAcute kidney injury (AKI) is associated with increased morbidity and mortality in critically ill patients. Olfactomedin 4 (OLFM4), a secreted glycoprotein expressed in neutrophils and stressed epithelial cells, is upregulated in loop of Henle (LOH) cells following AKI. We hypothesized that urine OLFM4 (uOLFM4) will increase in patients with AKI and may predict furosemide responsiveness.
methodsUrine from critically ill children was collected prospectively and tested for uOLFM4 concentrations with a Luminex immunoassay. Severe AKI was defined by KDIGO (stage 2/3) serum creatinine criteria. Furosemide responsiveness was defined as > 3 mL/kg/h of urine output in the 4 h after a 1 mg/kg IV furosemide dose administered as part of standard of care.
resultsFifty-seven patients contributed 178 urine samples. Irrespective of sepsis status or AKI cause, uOLFM4 concentrations were higher in patients with AKI (221 ng/mL [IQR 93-425] vs. 36 ng/mL [IQR 15-115], p = 0.007). uOLFM4 concentrations were higher in patients unresponsive to furosemide (230 ng/mL [IQR 102-534] vs. 42 ng/mL [IQR 21-161], p = 0.04). Area under the receiver operating curve for association with furosemide responsiveness was 0.75 (95% CI, 0.60-0.90).
conclusionsAKI is associated with increased uOLFM4. Higher uOLFM4 is associated with a lack of response to furosemide. Further testing is warranted to determine whether uOLFM4 could identify patients most likely to benefit from earlier escalation from diuretics to kidney replacement therapy to maintain fluid balance. A higher resolution version of the Graphical abstract is available as Supplementary information.
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