Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.

Jay L Koyner; Christian Arndt; Jaume Baldira Martinez de Irujo; Sílvia Coelho; Manuel Garcia-Montesinos de la Peña; Luca di Girolamo; Michael Joannidis; Pablo Jorge-Monjas; Christian Koch; Steven Lobaz; Alain Meyer; Marlies Ostermann; Nicoletta Pertica; John R Prowle; Jon Silversides; Alexander Zarbock; Jorge Echeverri; Kai Harenski; Lui G Forni

doi:10.1080/0886022X.2024.2345747

Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.

Jay L Koyner, Christian Arndt, Jaume Baldira Martinez de Irujo, Sílvia Coelho, Manuel Garcia-Montesinos de la Peña, Luca di Girolamo, Michael Joannidis, Pablo Jorge-Monjas, Christian Koch, Steven Lobaz, Alain Meyer, Marlies Ostermann, Nicoletta Pertica, John R Prowle, Jon Silversides, Alexander Zarbock, Jorge Echeverri, Kai Harenski, Lui G Forni

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Abstract

BACKGROUND: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions.

METHODS: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale).

RESULTS: Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan ( p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences.

CONCLUSION: Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.

Original language	English
Article number	2345747
Number of pages	8
Journal	Renal failure
Volume	46
Issue number	1
DOIs	https://doi.org/10.1080/0886022X.2024.2345747
Publication status	Published - 26 Apr 2024

Keywords

Acute Kidney Injury/urine
Humans
Biomarkers/urine
Delphi Technique
Renal Replacement Therapy
Consensus
Chemokines, CC/urine
Europe

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Assessing the role of Chemokine (C–C motif) ligand 14 in AKI: a European consensus meeting
Copyright 2024 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.62 MBLicence: CC BY

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Koyner, J. L., Arndt, C., Baldira Martinez de Irujo, J., Coelho, S., Garcia-Montesinos de la Peña, M., di Girolamo, L., Joannidis, M., Jorge-Monjas, P., Koch, C., Lobaz, S., Meyer, A., Ostermann, M., Pertica, N., Prowle, J. R., Silversides, J., Zarbock, A., Echeverri, J., Harenski, K., & Forni, L. G. (2024). Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting. Renal failure, 46(1), Article 2345747. https://doi.org/10.1080/0886022X.2024.2345747

@article{4a3821468fb3422a9c2d4365dae890bf,

title = "Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.",

abstract = "BACKGROUND: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions.METHODS: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80\% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale).RESULTS: Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan ( p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences. CONCLUSION: Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.",

keywords = "Acute Kidney Injury/urine, Humans, Biomarkers/urine, Delphi Technique, Renal Replacement Therapy, Consensus, Chemokines, CC/urine, Europe",

author = "Koyner, \{Jay L\} and Christian Arndt and \{Baldira Martinez de Irujo\}, Jaume and S{\'i}lvia Coelho and \{Garcia-Montesinos de la Pe{\~n}a\}, Manuel and \{di Girolamo\}, Luca and Michael Joannidis and Pablo Jorge-Monjas and Christian Koch and Steven Lobaz and Alain Meyer and Marlies Ostermann and Nicoletta Pertica and Prowle, \{John R\} and Jon Silversides and Alexander Zarbock and Jorge Echeverri and Kai Harenski and Forni, \{Lui G\}",

year = "2024",

month = apr,

day = "26",

doi = "10.1080/0886022X.2024.2345747",

language = "English",

volume = "46",

journal = "Renal failure",

issn = "0886-022X",

publisher = "Taylor and Francis",

number = "1",

}

Koyner, JL, Arndt, C, Baldira Martinez de Irujo, J, Coelho, S, Garcia-Montesinos de la Peña, M, di Girolamo, L, Joannidis, M, Jorge-Monjas, P, Koch, C, Lobaz, S, Meyer, A, Ostermann, M, Pertica, N, Prowle, JR, Silversides, J, Zarbock, A, Echeverri, J, Harenski, K & Forni, LG 2024, 'Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.', Renal failure, vol. 46, no. 1, 2345747. https://doi.org/10.1080/0886022X.2024.2345747

TY - JOUR

T1 - Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.

AU - Koyner, Jay L

AU - Arndt, Christian

AU - Baldira Martinez de Irujo, Jaume

AU - Coelho, Sílvia

AU - Garcia-Montesinos de la Peña, Manuel

AU - di Girolamo, Luca

AU - Joannidis, Michael

AU - Jorge-Monjas, Pablo

AU - Koch, Christian

AU - Lobaz, Steven

AU - Meyer, Alain

AU - Ostermann, Marlies

AU - Pertica, Nicoletta

AU - Prowle, John R

AU - Silversides, Jon

AU - Zarbock, Alexander

AU - Echeverri, Jorge

AU - Harenski, Kai

AU - Forni, Lui G

PY - 2024/4/26

Y1 - 2024/4/26

N2 - BACKGROUND: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions.METHODS: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale).RESULTS: Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan ( p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences. CONCLUSION: Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.

AB - BACKGROUND: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions.METHODS: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale).RESULTS: Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan ( p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences. CONCLUSION: Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.

KW - Acute Kidney Injury/urine

KW - Humans

KW - Biomarkers/urine

KW - Delphi Technique

KW - Renal Replacement Therapy

KW - Consensus

KW - Chemokines, CC/urine

KW - Europe

U2 - 10.1080/0886022X.2024.2345747

DO - 10.1080/0886022X.2024.2345747

M3 - Article

C2 - 38666354

SN - 0886-022X

VL - 46

JO - Renal failure

JF - Renal failure

IS - 1

M1 - 2345747

ER -

Assessing the role of Chemokine (C-C motif) ligand 14 in AKI: a European consensus meeting.

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