SynthesisCritical care (London, England)2023
Proenkephalin as a biomarker correlates with acute kidney injury: a systematic review with meta-analysis and trial sequential analysis.
Synthesis in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Serial plasma proenkephalin A 119-159 and dipeptidyl peptidase 3 after cardiac arrest: association with long-term neurological outcome.Resuscitation plus · 2026Article
- Proenkephalin A and Heterogeneity of Hydrocortisone Treatment Effect in Septic Shock: A Post Hoc Analysis of the VANISH Trial.Critical care explorations · 2026Observational
- Serum proenkephalin-A as a potential biomarker for assessing renal impairment severity in diabetic kidney disease.Irish journal of medical science · 2026Article
- Beyond Creatinine: Novel Renal Biomarkers at the Interface of Kidney Injury and Cardiovascular Risk.Biomedicines · 2026Review
- What new renal biomarkers tell us about renal physiology: Collection: physiology applied to ICU.Annals of intensive care · 2026Review
- Dynamics in kidney function markers as predictors of post-ICU survival: an innovative approach to enhance marker accuracy.Frontiers in medicine · 2026Article
- Proenkephalin a 119-159 for evaluating glomerular filtration rate and hemodialysis adequacy in patients with end-stage kidney disease: a prospective cohort study.Frontiers in medicine · 2026Article
- Proenkephalin A for assessing kidney integrity and guiding KRT liberation decisions in critically ill patients.Annals of intensive care · 2026Article
- Acute Kidney Injury Biomarkers in Perioperative Care: A Scoping Review of Clinical Implementation.Diagnostics (Basel, Switzerland) · 2025Review
- Proenkephalin A 119-159 as a biomarker for predicting sepsis-associated acute kidney injury.International urology and nephrology · 2025Article
- Evaluation of a Novel Biomarker Panel for Acute Kidney Injury Following Endovascular Aortic Repair.International journal of molecular sciences · 2025Article
- Association of Osteopontin and selective glomerular hypofiltration syndrome with hospitalization for kidney failure in acute heart failure patients.BMC nephrology · 2025Article
- Integrating Novel Biomarkers into Clinical Practice: A Practical Framework for Diagnosis and Management of Cardiorenal Syndrome.Life (Basel, Switzerland) · 2025Review
- The Prognostic Utility of Pathophysiologically Distinct Biomarkers for Renal Outcomes in Sepsis: A Prospective ICU Cohort Study.Journal of clinical medicine · 2025Article
- Proenkephalin A 119-159 as an early biomarker of acute kidney injury in complex endovascular aortic repair: an explorative single-center cross-sectional study with the utilization of two measurement methods.Perioperative medicine (London, England) · 2025Article
- Preventing acute kidney injury and its longer-term impact in the critically ill.Intensive care medicine · 2025Review
- Biomarkers as Beacons: Illuminating Sepsis-Associated Hepato-Renal Injury.International journal of molecular sciences · 2025Review
- An Atypical Case of Rhabdomyolysis Following an Atypical Antidepressant Overdose.Journal of clinical medicine · 2025Article
- Proenkephalin improves cardio-renal risk prediction in acute coronary syndromes: the KID-ACS score.European heart journal · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundProenkephalin A 119-159 (PENK) is freely filtered in the glomerulus with plasma levels correlating with glomerular filtration rate. Therefore, PENK has been proposed as an early indicator of acute kidney injury (AKI) although its performance is dependent on the clinical setting. This meta-analysis aimed to investigate the correlation between PENK levels and the development of AKI.
methodsWe conducted a comprehensive search on the PubMed, Embase, Cochrane databases, the website ClinicalTrials.gov and Cnki.net until June 26, 2023. Summary receiver operating characteristic (SROC) curves were used to amalgamate the overall test performance. Diagnostic odds ratio (DOR) was employed to compare the diagnostic accuracy of PENK with other biomarkers. Quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria.
resultsWe incorporated 11 observational studies with 3969 patients with an incidence of AKI of 23.4% (929 out of 3969 patients) with the best optimal cutoff value of PENK for early detection of AKI being 57.3 pmol/L. The overall sensitivity and specificity of PENK in identifying AKI were 0.69 (95% CI 0.62-0.75) and 0.76 (95% CI 0.68-0.82), respectively. The combined positive likelihood ratio (LR) stood at 2.83 (95% CI 2.06-3.88), and the negative LR was 0.41 (95% CI 0.33-0.52). The SROC curve showcased pooled diagnostic accuracy of 0.77 (95% CI 0.73-0.81). Interestingly, patients with a history of hypertension or heart failure demonstrated a lower specificity of PENK in correlating the development of AKI.
conclusionOur results indicate that PENK possesses significant potential as a biomarker for the early detection of the development of AKI, using a cutoff point of 57.3 pmol/L for PENK.
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