Clinical journal of the American Society of Nephrology : CJASN
September 16, 2026 · via Europe PMC
Validation of Urinary C-C Motif Chemokine Ligand 14 for Persistent Severe AKI Using Clinical Adjudication.
Kampf JP, Al-Khafaji A, Arora S, +16 more, Koyner JL.
AI summary — for doctors, generated from the abstract only
In a multicenter ICU study (the Diamond Study), urinary CCL14 was validated as being associated with a higher risk of persistent severe acute kidney injury (including need for kidney replacement therapy and death) in patients with established Stage 2 or 3 AKI.
What was studied
This multicenter prospective observational study enrolled 476 ICU patients with KDIGO Stage 2 or 3 AKI within the prior 36 hours, measuring urinary CCL14 at enrollment and using a clinical adjudication committee of three nephrologists to determine the primary endpoint of persistent severe AKI (Stage 3 AKI lasting ≥72 hours), evaluating previously established CCL14 cutoffs of 1.3 and 13 ng/mL.
Key findings
- 151 of 476 patients (32%) were adjudicated to have persistent severe AKI.
- Patients with persistent severe AKI had higher APACHE III scores and more Stage 3 AKI at enrollment than those without, though the exact comparative statistics for these differences are truncated/garbled in the available abstract text.
- Urinary CCL14 was associated with a higher risk of persistent severe AKI, including subsequent kidney replacement therapy initiation and death, though specific effect sizes (e.g., odds ratios, AUC) at the pre-specified cutoffs are not given in the available abstract text.
- Not reported in the abstract: the abstract's results section is cut off before key quantitative performance metrics (e.g., sensitivity, specificity, or risk ratios at the 1.3 and 13 ng/mL cutoffs) are presented.
Clinical relevance
The findings suggest urinary CCL14 may help identify ICU patients with established AKI who are at higher risk of progressing to persistent severe AKI, which could be relevant for enriching future AKI treatment trials or care pathways with high-risk patients. Without the specific effect-size data, the degree of added clinical value beyond existing adjudication criteria cannot be fully assessed from this abstract.
Who should care
Limitations
The abstract text is truncated in the results section, omitting key quantitative findings (effect sizes, specific risk estimates at the pre-specified cutoffs); important additional limitations may not be assessable from the abstract alone.
Urinary CCL14 was associated with higher risk of persistent severe AKI, kidney replacement therapy, and death in ICU patients with established AKI, though the abstract's detailed performance statistics were not fully available.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Urinary C-C motif chemokine ligand 14 (CCL14) has been demonstrated to prognosticate persistent severe acute kidney injury (PS-AKI) in patients with established AKI. We sought to validate the performance of CCL14 among intensive care unit (ICU) patients, at previously established cutoffs of 1.3 and 13 ng/mL.
Methods
The Diamond Study was a multi-center prospective observational study of ICU patients with KDIGO Stage 2 or 3 AKI within the last 36 hours. Urine was collected at enrollment for CCL14 measurement. The primary study endpoint was the development of PS-AKI (Stage 3, lasting for ≥72 hours) as determined by a clinical adjudication committee consisting of three nephrologists with expertise in AKI.
Results
We enrolled 476 patients with CCL14 measurements and 151 (32%) were adjudicated to have PS-AKI. At enrollment, PS-AKI patients had higher APACHE III scores and more Stage 3 AKI (p<0.002 for both). Ninety-five (20%) patients received kidney replacement therapy (KRT), 98 (21%) died, and 155 (33%) received KRT and/or died within 30 days. The area under the receiver operating characteristic curve (95% CI) for CCL14's prediction of PS-AKI was 0.70 (0.65-0.76). The sensitivity at the 1.3 ng/mL cutoff was 78.1% (70.9%-84.0%), while the specificity was 49.8% (44.4%-55.3%). For every 1 ng/mL increase in CCL14, there was a 6% higher rate of KRT initiation; with values above 13 ng/mL having a hazard ratio (95%CI) of 5.70 (3.22-10.11) for need for KRT and 3.50 (2.19-5.60) for need for KRT or death relative to values ≤1.3 ng/mL (p<0.001 for all).
Conclusions
In ICU patients with Stage 2 or 3 AKI, urinary CCL14 is associated with a higher risk of PS-AKI, including KRT initiation and death. Future efforts to treat AKI could be enriched using CCL14 to target those at high risk for PS-AKI.
DOI
10.2215/cjn.0000001212
PMID
42747895
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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