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

Publisher: Informa Healthcare Country of Publication: England NLM ID: 8701128 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-6049 (Electronic) Linking ISSN: 0886022X NLM ISO Abbreviation: Ren Fail Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: New York, N.Y. : M. Dekker, c1987-

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

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.

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Keywords: Biomarker testing experience; C‑C motif chemokine ligand 14 (CCL14); consensus; critical care nephrology; persistent acute kidney injury

0 (Biomarkers)
0 (Chemokines, CC)

Date Created: 20240426 Date Completed: 20240426 Latest Revision: 20240501

20240501

PMC11057457

10.1080/0886022X.2024.2345747

38666354