{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:10:13Z","timestamp":1789575013205,"version":"build-2803163510"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"\n Background:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n 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 \u226572 hours) as determined by a clinical adjudication committee consisting of three nephrologists with expertise in AKI.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n 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\u2019s 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 \u22641.3 ng\/mL (p<0.001 for all).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000001212","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:00:12Z","timestamp":1789574412000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Validation of Urinary C-C Motif Chemokine Ligand 14 for Persistent Severe AKI Using Clinical Adjudication"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3050-3998","authenticated-orcid":false,"given":"J. Patrick","family":"Kampf","sequence":"first","affiliation":[{"name":"Astute Medical, Inc. (a bioM\u00e9rieux, Inc. company), San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al-Khafaji","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Allegheny Health Network, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anahat","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Southern California Keck School of Medicine, Los Angeles CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0533-3192","authenticated-orcid":false,"given":"Michael","family":"Heung","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-3683","authenticated-orcid":false,"given":"Kianoush","family":"Kashani","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2622-4267","authenticated-orcid":false,"given":"Marcos G.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Szalados","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Neurology, and Anesthesiology, Rochester Regional Health System, Rochester General Hospital, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2445-0386","authenticated-orcid":false,"given":"Ashita","family":"Tolwani","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8527-4195","authenticated-orcid":false,"given":"Richard G.","family":"Wunderink","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care Division, Department of Medicine, Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-2653","authenticated-orcid":false,"given":"John A.","family":"Kellum","sequence":"additional","affiliation":[{"name":"Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8677-9187","authenticated-orcid":false,"given":"Fei","family":"Zheng","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Grosz","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-894X","authenticated-orcid":false,"given":"Ludovic","family":"Brossault","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Coronella","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Octave","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9163-7864","authenticated-orcid":false,"given":"Sandrine","family":"Michel-Busseret","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia de la","family":"Salle","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chlo\u00e9","family":"Geller","sequence":"additional","affiliation":[{"name":"bioM\u00e9rieux, Marcy-l'\u00c9toile, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6873-8712","authenticated-orcid":false,"given":"Jay L.","family":"Koyner","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,16]]},"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001212","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:00:12Z","timestamp":1789574412000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001212","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"assertion":[{"value":"2026-01-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}