Proenkephalin as biomarker for acute renal injury - a systematic review

Recently published systematic review and meta-analysis aimed to investigate the correlation between Proenkephalin A 119-159 (PENK) levels and the development of acute kidney injury (AKI). The review incorporated 11 observational studies with 3969 patients, and the overall sensitivity and specificity of PENK in identifying AKI were found to be 0.69 and 0.76, respectively. The combined positive likelihood ratio (LR) stood at 2.83, and the negative LR was 0.41. The study also determined the optimal cutoff value of PENK for early detection of AKI to be 57.3 pmol/L, and the SROC curve showcased a pooled diagnostic accuracy of 0.77. Patients with a history of hypertension or heart failure demonstrated a lower specificity of PENK in correlating the development of AKI. Further analyses suggested that patients with heart failure and hypertension may result in a higher false-positive rate when using PENK as an early indicator of AKI.

Conclusion on PENK's Potential as a Biomarker for AKI

The study concluded 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. The article also highlighted the need for additional clinical trials and real-world studies to validate the utility of PENK as a biomarker for anticipating AKI onset. The findings from the systematic review and meta-analysis support the potential of PENK as a biomarker for incident AKI with high positive and negative likelihood ratios. Additionally, a distinct cutoff value for PENK was established, enhancing its utility in excluding the possibility of AKI.