Assessing Post-Cardiac Surgery Kidney Recovery Through PenKid's Emerging Role in Renal Replacement Therapy Decisions

• Proenkephalin A 119-159 (penKid) demonstrates potential as a predictor for successful discontinuation of continuous renal replacement therapy (CRRT) in cardiac surgery patients.
• Study reveals significant differences in penKid levels between patients successfully and unsuccessfully liberated from CRRT.
• Findings suggest penKid could be a valuable tool in guiding CRRT liberation decisions.

Hennigsdorf/Berlin, Germany, January 9, 2025 - Diagnostic company SphingoTec GmbH ("SphingoTec") announces results from the first prospective study, conducted at the Medical University of Vienna, demonstrating penKid as a discriminatory biomarker for successful liberation from CRRT in cardiac surgery patients with acute kidney injury (AKI) (1).

AKI remains a significant challenge in hospitals and is not limited to emergency cases, affecting a substantial number of up to 40% of elective cardiac surgery patients (2,3).  When prolonged or further complicated, the use of CRRT might become necessary, which is one of the most resource-intensive interventions. Determining the optimal time to discontinue CRRT has been a persistent clinical challenge. The research, led by Ap. Prof. PD DDr. Martin Bernardi and colleagues, provides new insights into the utility of this biomarker.

Key Findings
The study revealed that patients successfully liberated from CRRT had significantly lower penKid levels compared to those unsuccessfully liberated (1). This distinction was particularly notable at the time of CRRT liberation. "Our findings suggest that penKid could be a valuable tool in supporting clinical decisions regarding CRRT discontinuation," stated Prof. Bernardi. "Additionally, this biomarker shows potential in identifying patients who are likely to maintain kidney function after CRRT is stopped."
Supporting evidence comes from post-hoc analyses of the RICH (5) and ELAIN (6) trials, which consistently demonstrate penKid's capability to predict kidney function recovery under renal replacement therapy and successful treatment liberation.

Bridging Gaps in AKI Management
As the critical care community continues to optimize AKI management protocols in cardiac surgery patients and beyond, penKid stands out as a promising biomarker that could refine current acute dialysis management strategies, particularly in determining optimal timing for CRRT discontinuation. For more information, Prof. Bernardi will be discussing these findings and their implications in an upcoming webinar titled "Practice-Oriented Management of Acute Dialysis in Cardiac Surgery Patients: Strategies and Challenges in Clinical Practice."

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References:

1. Tichy J, et.al. Prediction of Successful Liberation from Continuous Renal Replacement Therapy Using a Novel Biomarker in Patients with Acute Kidney Injury after Cardiac Surgery-An Observational Trial. Int J Mol Sci. 2024 Oct 10;25(20):10873. doi: 10.3390/ijms252010873.
2. Grams, M.E. et. al. Acute Kidney Injury after Major Surgery: A Retrospective Analysis of Veterans Health Administration Data. Am. J. Kidney Dis. 2016, 67, 872–880.
3. Wang, Y. et al. Cardiac surgery-associated acute kidney injury: Risk factors, pathophysiology and treatment. Nat. Rev. Nephrol. 2017, 13, 697–711.
4. Lorenzin A, et al. Human Proenkephalin A 119-159 (penKid) in Extracorporeal Therapies: Ex vivo Sieving Coefficient, Diffusive Clearance, and Hemoadsorption Kinetics. Blood Purif. 2024;53(10):773-780. doi: 10.1159/000540061.
5. von Groote T et al. Proenkephalin A 119–159 predicts early and successful liberation from renal replacement therapy in critically ill patients with acute kidney injury: a post hoc analysis of the ELAIN trial. Crit Care 26, 333 (2022). doi.org/10.1186/s13054-022-04217-4
6. (3) von Groote T, et al. Evaluation of Proenkephalin A 119-159 for liberation from renal replacement therapy: an external, multicenter pilot study in critically ill patients with acute kidney injury. Crit Care. 2023 Jul 10;27(1):276. doi: 10.1186/s13054-023-04556-w.

About SphingoTec
SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a diagnostic company focusing on the out-licensing of innovative critical care biomarkers for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, commercially available on diagnostic platforms AFIAS and Nexus IB10 and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like sepsis. Discover more on www.sphingotec.com

Contact:
Ruxandra Lenz
Head of Marketing and Communication
SphingoTec GmbH
Phone +49-3302-20565-0
Email: press@sphingotec.com