Proenkephalin A for assessing kidney integrity and guiding kidney replacement therapy (KRT) liberation decisions in critically ill patients
Authors' conclusion
PENK may reflect kidney integrity independent of KRT, enhance residual kidney function assessment, and may aid prediction of KRT liberation failure
Study context
- Population
- Critically ill patients at Heidelberg University Hospital; subgroup receiving KRT for liberation analyses138 on KRT in liberation subgroup
- Participants
- 1,436 patients
- Outcome
- PENK for AKI staging, residual kidney function and KRT liberation failure
Methodological detailsreal-world, single-centre
- Real-world
- Single-centre
Main finding
As reported in the abstract
- Acute kidney injury (AKI) incidence
- 621 (43.2%)
- Acute KRT required
- 12.6%
- Successfully liberated from KRT
- 40.9%
- Liberation failed
- 24.3%
- No liberation attempt
- 31.5%
- Lost to follow up
- 3.3%
- PENK cut-off ≥250 pmol/L: specificity for liberation failure
- >90%
Observational data: associations, not effects.
Original publication
Proenkephalin A for assessing kidney integrity and guiding KRT liberation decisions in critically ill patients. Ann Intensive Care. Published 21 July 2026. doi:10.
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