sphingotec announces new data on the kidney function marker proenkephalin (penKid®) presented at 24th International Conference on Advances in Critical Care Nephrology
sphingotec announces new data on the kidney function marker proenkephalin (penKid®) presented at 24th International Conference on
Advances in Critical Care Nephrology
- Medical leaders in renal critical care presented study data at the 24th AKI & CRRT conference supporting the hypothesis that plasma penKid® levels reflect kidney function in critically ill burn patients, heart failure patients, and sepsis patients closing the gap to near-time diagnosis and monitoring of acute kidney injury (AKI).
- Peer-reviewed results from the Valsartan Heart Failure Trial (Val-HeFT) comparing the biological variation of renal biomarker tests demonstrate that sphingotest® penKid® is the very first diagnostic test capable to rule out AKI with a single measurement and best-in-class in terms of early diagnosis.
- Medical leaders recommend to include low penKid® levels as exclusion criterion for AKI in triaging and for routine testing at emergency departments.
- Critical care experts announced to evaluate clinical utility of sphingotest® penKid® in renal transplant function/dysfunction.
- Automated point-of-care (POC) penKid® testing on NEXUS IB 10 platform to be launched at intensive care units (ICUs) and emergency departments (EDs) by summer 2019.
HENNIGSDORF, GERMANY - March 14, 2019
- German diagnostics company SphingoTec GmbH (Hennigsdorf) announced that leaders in critical care nephrology have confirmed clinical utility of the company’s glomerular filtration biomarker penKid® for early diagnosis, exclusion and monitoring of acute kidney injury (AKI). Data from prospective, observational studies presented at the 24th International Conference on Advances in Critical Care Nephrology (AKI & CRRT; 26 Feb-1 March, 2019) in San Diego demonstrate that penKid® is suitable to guide treatment decisions at ICUs and EDs.
At the AKI & CRRT conference, Prof. Matthieu Legrand (Critical Care Medicine & Burn Unit at Hôpital Lariboisière Paris, France) reported results from a substudy of the PRONOburn cohort that enrolled 113 burn patients admitted to burn intensive care units (ICUs). High penKid® levels at admission (> 80 pmol/L) were sufficient to predict acute kidney injury (AKI) even when other indicators such as the SOFA score gave no sufficient information (p<0.001). In sepsis patients, enrolled in the FROG-ICU and AdrenOSS-1 cohorts, including more than 1,100 patients, elevated penKid® plasma levels identified sub-AKI while creatinine values remained normal (1 out of 4 patients). Sub-AKI was associated
with worse outcomes.
Peer-reviewed data [1] on the biological variation of four AKI biomarker tests in patients with stable heart disease presented by Dr. Alan Wu (UCLA, San Francisco) demonstrated that penKid® is best suited for early diagnosis of renal insufficiency in clinical practice. Data from 85 individuals enrolled in the Valsartan Heart Failure Trial (Val-HeFT) support that penKid® testing would be of value in managing patients in EDs and ICUs. Commenting on the results, key opinion leaders suggested to add penKid® measurements to AKI routine testing for triaging and monitoring, which today only allows delayed information using available biomarkers.
“The biovariability of a biomarker is a key attribute, but not tested for many of the novel kidney markers. penKid® shows a low variability – allowing information with the first measurement,” said Dr. Wu. “penKid® has a huge value to rule out patients in EDs,” confirmed Prof. Salvatore Di Somma, Head of Emergency Medicine Sant'Andrea Hospital, Rome, Italy. sphingotec showed data from pilot routine testing, which has already begun at undisclosed ICUs and EDs in Germany. Study leaders confirmed that triaging will be supported by penKid® information, because the marker can rule out AKI as BNP rules out Heart Failure. David Bruno, Director of the University of Maryland Transplant Surgery Program announced starting tests with penKid® to predict graft function recovery in kidney transplantation.
Plasma penKid® is a surrogate marker for disturbed renal glomerular filtration rate (GFR), which reflects kidney function. Previous studies on more than 30,000 critically ill patients admitted to EDs or ICUs with congestive heart failure [2] or sepsis [3] demonstrated that penKid® levels change dynamically with the actual kidney function independently from comorbidities or inflammation [4]. penKid® levels rise up to 48 hours prior to those of creatinine preceding kidney injury (AKI), which affects about 25 percent of patients admitted to ICUs.
By the end of H1/2019, sphingotec will launch a penKid® point-of-care (POC) test on its fully automated Nexus IB10 POC testing platform for use in EDs and ICUs. The platform allows measurement of up to five critical care biomarker tests in one run within 20 minutes without any sample preparation.
[1] Wu, A., Anand, I. (2018) Biological variation of plasma proenkephalin: data from a stable heart failure cohort.
[2] Chan S. et al. (2018) Proenkephalin in Heart Failure; Kanagala P. et al.: Proenkephalin and prognosis in heart failure with preserved ejection fraction: a GREAT network study.
[3] Hollinger et al. (2018) Proenkephalin A 119-159 (Penkid) Is an Early Biomarker of Septic Acute Kidney Injury: The Press Release Kidney in Sepsis and Septic Shock (Kid-SSS) Study
[4] Beunders, R. et al. (2017) Proenkephalin (PENK) as a novel biomarker for kidney function.
About SphingoTec GmbH:
SphingoTec GmbH (Hennigsdorf, Germany) is developing and marketing innovative biomarkers such as penKid® and bioADM® for prediction, diagnosis and therapy monitoring of AKI, congestive heart failure and septic shock, as well as the Nexus IB10 POC testing immunoassay platform acquired from Samsung-subsidiary Nexus Dx Inc. in May 2018. The company, founded by Dr. Andreas Bergmann in 2002, in addition is developing a pipeline of novel biomarkers which can predict the risks of obesity, breast cancer and cardiovascular diseases.
About International Conference on Advances in Critical Care Nephrology:
The AKI & CRRT conference provides a comprehensive review of advances in clinical care, research and technology in critical care medicine with a focus on the
kidney and renal support techniques.
About penKid®:
penKid® is the very first functional kidney marker that works in blood. penKid® is independent from comorbidities and inflammation and provides timely information about the changing kidney function in critically ill patients. sphingotest® penKid® is non-inferior to the gold standard in vivo measurement of glomerular filtration rate (GFR). These features enable physicians to diagnose and closely monitor worsening and improving kidney function in critically ill patients.

A new peer-reviewed study in Physiological Reports is the first to evaluate Proenkephalin A 119-159 (penKid) for kidney functional reserve (KFR) assessment, a stress test designed to reveal loss of kidney capacity that may not be apparent from routine blood tests. Within that method, penKid stood out: its dynamic had a far wider range after a protein stimulus than cystatin C (44.2% vs. 10.5% median fractional change) while reaching its maximal response within approx. two hours after protein stimulation. The results extend the published evidence for penKid beyond acute kidney injury into a potential complementary application: assessing kidney functional reserve. Hennigsdorf, Germany – October 6, 2026 – penKid has been evaluated for the first time as a marker of kidney functional reserve (KFR): a new study in Physiological Reports (1) found that its response spanned a much wider range than cystatin C and creatinine clearance after a protein stimulus. The study in 62 participants marks the first published evaluation of penKid for this use. Clinical context and unmet need Kidney function may appear normal on a standard blood test until a large portion of capacity has already gone. Kidney functional reserve testing addresses this gap by measuring how much a kidney's filtration rate can still rise in response to a stimulus, most commonly a protein meal. Once that reserve narrows, the kidney has less room to compensate for future stress such as major surgeries. The study authors note that reserve testing is rarely used in clinical practice, largely because the reference method used, creatinine clearance, is cumbersome, requiring blood and urine collection, can be difficult to perform outside specialized settings, and is affected by processes in the kidney unrelated to filtration itself. Study design and key findings Researchers at the University of New South Wales and Prince of Wales Hospital in Sydney conducted the study in 62 participants: 40 patients having heart surgery, and 22 healthy people, including volunteers, kidney donors, and patients who had a kidney auto-transplant. Participants drank a protein shake, followed by hourly collection of blood samples over a five hour-period. Urine samples were also collected for creatinine clearance testing. After a high protein intake, kidney filtration increases for a few hours: this "extra work" is what the methods were designed to measure. PenKid showed the largest dynamic response, with a median fractional increase of 44% from baseline compared with 30% for creatinine clearance and only about 10% for cystatin C. Unlike creatinine clearance, penKid differentiated healthy participants from cardiac surgery patients, who had a lower KFR. The study also found penKid measurements to be more homogeneous than creatinine clearance measurements, indicating greater consistency across assessments. PenKid was also fast, reaching its peak functional response in about two hours, similar in timing to a two-hour diabetes test (oral glucose tolerance test). Implications for clinical practice Beyond its wider dynamic range, the authors highlight practical advantages specific to penKid-based functional reserve testing: no urine collection is needed, minimal fasting is required, and penKid enables near real-time assessment of kidney functional reserve from blood samples alone. These features suggest penKid may offer a fast and simple alternative to assess how much reserve an individual patient has. "PenKid gave us a fast, consistent read on how much filtration capacity a kidney still has in reserve," said Prof. Zoltan H. Endre, corresponding author of the study, Department of Nephrology, Prince of Wales Hospital, and School of Clinical Medicine, University of New South Wales, Sydney. "A signal that's clear, captured that quickly, turns a kidney stress test from a research tool into something a clinic could actually use." About penKid, scientific insights PenKid is a biomarker for real-time assessment of kidney function. Unlike creatinine, penKid levels are not influenced by inflammation or factors such as age or sex, and prior studies show penKid can detect acute kidney injury (AKI) up to 48 hours before conventional criteria are met (2,3). The new Physiological Reports study provides data for another, complementary application: measuring kidney functional reserve to identify subclinical kidney disease. About SphingoTec SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a biomarker company focusing on the out-licensing of innovative critical care solutions for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like acute heart failure. Discover more on www.sphingotec.com References (1) Rodrigues, C. E. et. al. (2026). Plasma proenkephalin-a facilitates measurement of human kidney functional reserve: From healthy kidney donors to polymorbid patients. Physiological Reports, 14, e71083. https://doi.org/10.14814/phy2.71083 . (2) Caironi P, et al. (2018) Circulating Proenkephalin, Acute Kidney Injury, and Its Improvement in Patients with Severe Sepsis or Shock.; https://doi.org/10.1373/clinchem.2018.288068 (3) Rosenqvist M, et. al. (2019) Proenkephalin a 119-159 (penKid) - a novel biomarker for acute kidney injury in sepsis: an observational study. BMC Emerg Med, doi: 10.1186/s12873-019-0283-9. Media Contact: Email: press@sphingotec.com Phone +49-3302-20565-0 SphingoTec GmbH Neuendorfstr. 15A 16761 Hennigsdorf, Germany

In a prospective, real-world study of 1,436 critically ill ICU patients, proenkephalin A 119–159 (penKid) provided clinically relevant information across AKI severity and during kidney replacement therapy (KRT). PenKid addressed a key unmet need in KRT management by identifying, with greater precision than standard biomarkers, patients at high risk of KRT liberation failure – helping to avoid stopping therapy too early. The findings support a future role for penKid in helping to standardize one of the few intensive care processes where the need for better decision support is widely acknowledged and current tools remain insufficient. Hennigsdorf, Germany – August 27, 2026 – SphingoTec GmbH announces the publication of new real-world data on proenkephalin A 119–159 (penKid) in critically ill patients. The data, published in Annals of Intensive Care, add to the growing body of evidence supporting penKid as a functional biomarker for kidney function and help inform clinical decision-making in AKI and KRT (1). In a prospective observational study at Heidelberg University Hospital, penKid was measured in 1,436 critically ill patients, including 138 patients receiving KRT for liberation analyses. The findings showed that penKid rose with AKI severity and, unlike serum creatinine and urine output, distinguished stage 3 AKI patients with and without an acute KRT requirement. In contrast to serum creatinine, penKid also differentiated acute KRT patients from those with pre-existing kidney failure and on chronic hemodialysis prior ICU admission, even while KRT treatment was ongoing (1). The study further showed that penKid levels increased progressively from the start of KRT, while serum creatinine decreased under treatment. Following successful liberation from KRT, penKid declined, whereas higher levels were seen in cases of liberation failure. In multivariable analysis, penKid was the strongest independent predictor of liberation failure and outperformed serum creatinine. A penKid cut-off of ≥250 pmol/L provided more than 90% specificity for liberation failure (1). By identifying patients at high risk of unsuccessful liberation, penKid may help clinicians make KRT discontinuation decisions more objectively, reduce the risk of stopping therapy too early, and support more standardized decision-making across critical care settings. “These data are important because they address a real-world clinical problem: how to better assess kidney function and support KRT decisions when standard markers fall short,” said Deborah Bergmann, CEO of SphingoTec. “penKid provides clinicians with an objective, real-time measurable parameter that may help support more informed and consistent kidney-related decisions in critical care.” Christian Nusshag, MD, Department of Nephrology, Heidelberg University Hospital, said: “Current markers often leave clinicians with an incomplete picture. Our findings suggest that penKid may help standardize decision-making by providing additional, actionable information on kidney integrity and recovery.” About penKid, scientific insights PenKid is a biomarker that enables real-time assessment of kidney function. Unlike conventional markers such as serum creatinine, penKid levels are not influenced by inflammation or other confounding factors like age or sex. Studies have shown that penKid allows earlier detection of AKI, predicting changes in serum creatinine up to 48 hours before conventional diagnostic criteria are met. This early detection capability is particularly valuable in critically ill patients, including those with sepsis or septic shock. Additionally, penKid has shown potential for monitoring renal recovery under KRT and could help predict successful liberation from KRT. About SphingoTec SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a biomarker company focusing on the out-licensing of innovative critical care solutions for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like acute heart failure. Discover more on www.sphingotec.com References (1) Gabriel DC, Sauer P, Happel R, et al. Proenkephalin A for Assessing Kidney Integrity and Guiding KRT Liberation Decisions in Critically Ill Patients. Annals of Intensive Care. 2026. DOI: 10.1016/j.aicoj.2026.100113. Media Contact: Email: press@sphingotec.com Phone +49-3302-20565-0 SphingoTec GmbH Neuendorfstr. 15A 16761 Hennigsdorf, Germany
