Urinary biomarker evaluation for early detection of gentamycin-induced acute kidney injury

Drug-induced acute kidney injury is a serious problem in drug development and clinical treatment. Thus, highly efficient and non-invasive urinary biomarkers are required to control and prevent drug-induced acute kidney injury. Expanding on a previous study, we evaluated 9 novel urinary biomarkers in beagles, which were treated with gentamycin at a dose of 40 mg/kg for 12 consecutive days. N-acetyl-β-D-glucosaminidase was detected with high sensitivity and specificity at the early stage of renal injury (Area under the ROC cure (AUC) = 0.929, 95%CI: 0.722-0.995, P < 0.05 vs. serum creatinine and blood urea nitrogen). More importantly, the results indicated that albumin and trefoil factor-3 were significantly increased 6 days after gentamycin injection (compared with the control group, both P < 0.05). Receiver operator characteristics analysis showed that the diagnostic value of these two biomarkers were both high (both AUCs=1.000; both 95% CI: 0.832-1.000; albumin or trefoil factor-3 vs. serum creatinine or blood urea nitrogen, both P < 0.05). Moreover, albumin and trefoil factor-3 levels were highly correlated to the degree of kidney injury (both Pearson's r > 0.8, P < 0.05). Our data indicate that albumin and trefoil factor-3 may have value in the early diagnosis of kidney injury in non-rodent species and may thus inspire the preclinical use of urinary biomarkers in drug-induced acute kidney injury.