CJASN
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Published ahead of print on May 14, 2009
Clinical Journal of the American Society of Nephrology
© 2009 American Society of Nephrology
doi: 10.2215/CJN.05411008
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
CJN.05411008v1
4/6/1020    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lu, J. C.T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lu, J. C.T.

Received October 21, 2008
Accepted on March 13, 2009

ORIGINAL ARTICLES

Searching for Genes That Matter in Acute Kidney Injury: A Systematic Review

Jonathan C.T. Lu , Steven G. Coca *{dagger}, Uptal D. Patel {ddagger}, Lloyd Cantley *, Chirag R. Parikh *1, and Translational Research Investigating Biomarkers and Endpoints for Acute Kidney Injury (TRIBE-AKI) Consortium

*Yale University School of Medicine, New Haven, Connecticut; {dagger}Clinical Epidemiology Research Center, VA Medical Center, West Haven, Connecticut; {ddagger}Duke University School of Medicine, Durham, North Carolina


1 To whom correspondence should be addressed. E-mail: Chirag.parikh{at}yale.edu.


  Abstract

Background and Objectives: Identifying patients who may develop acute kidney injury (AKI) remains challenging, as clinical determinants explain only a portion of individual risk. Another factor that likely affects risk is intrinsic genetic variability. Therefore, a systematic review of studies was performed that related the development or prognosis of AKI to genetic variation.

Design, setting, participants, and measurements: MEDLINE, EMBASE, HuGEnet, SCOPUS, and Web of Science were searched for articles from 1950 to Dec 2007. Two independent researchers screened articles using predetermined criteria. Studies were assessed for methodological quality via an aggregate scoring system.

Results: The 16 included studies were of cohort or case-cohort design and investigated 35 polymorphisms in 21 genes in association with AKI. Fifteen gene-gene interactions were also investigated in four separate studies. Study populations were primarily premature infants or adults who were critically ill or postcardiac bypass patients. Among the studies, five different definitions of AKI were used. Only one polymorphism, APO E e2/e3/e4, had greater than one study showing a significant impact (P < 0.05) on AKI incidence. The mean quality score of 5.8/10 (range four to nine), heterogeneity in the studies, and the dearth of studies precluded additional meta-analysis of the results.

Conclusions: Current association studies are unable to provide definitive evidence linking genetic variation to AKI. Future success will require a narrow consensus definition of AKI, rigorous epidemiologic techniques, and a shift from a priori hypothesis-driven to genome-wide association studies.




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 2009 by the American Society of Nephrology.