A basic science view of acute kidney injury biomarkers

Charlton, Jennifer R.; Portilla, Didier; Okusa, Mark D.

doi:10.1093/ndt/gft510

Cited by 247 publications

(256 citation statements)

References 122 publications

(136 reference statements)

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“…The characteristics of an ideal biomarker have been cited by many authors, [31][32][33] and a list of these is given in Table 1. Since the clinical features and the management of CI-AKI are the same as those for AKI due to other causes, 34,35 the biomarkers studied to predict an early diagnosis of other types of AKI can also be used to predict CI-AKI.…”

Section: Diagnosis Of Ci-aki: the Necessity For Novel Biomarkersmentioning

confidence: 99%

“…32 Thus, NGAL has the potential to act as a powerful and independent predictor of AKI. [78][79][80][81] Many clinical studies and reviews are reported in the literature concerning the potential role of NGAL as a reliable diagnostic and prognostic biomarker of AKI, since its serum and urinary levels increase earlier and show a better sensitivity than serum creatinine.…”

Section: Neutrophil Gelatinase-associated Lipocalinmentioning

confidence: 99%

“…7) Timed collection of urine is cumbersome and not accurate. 32,40,41 Blood urea nitrogen (BUN) has also been used to diagnose AKI and, like serum creatinine, is not an ideal marker of kidney injury, its levels being dependent on nonrenal factors that are independent of kidney function. 42 …”

mentioning

confidence: 99%

“…Moreover, the analytic evaluation of Cys-C is modified by many associated pathologic conditions. 32 The cellular injury in the renal proximal tubules will cause the appearance of Cys-C in the urine much earlier than the occurrence of histologic changes in proximal tubular epithelium. When compared with serum Cys-C, urine Cys-C appears to be an earlier biomarker of AKI.…”

mentioning

confidence: 99%

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The potential use of biomarkers in predicting contrast-induced acute kidney injury

Andreucci¹,

Faga²,

Riccio³

et al. 2016

IJNRD

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Contrast-induced acute kidney injury (CI-AKI) is a problem associated with the use of iodinated contrast media, causing kidney dysfunction in patients with preexisting renal failure. It accounts for 12% of all hospital-acquired kidney failure and increases the length of hospitalization, a situation that is worsening with increasing numbers of patients with comorbidities, including those requiring cardiovascular interventional procedures. So far, its diagnosis has relied upon the rise in creatinine levels, which is a late marker of kidney damage and is believed to be inadequate. Therefore, there is an urgent need for biomarkers that can detect CI-AKI sooner and more reliably. In recent years, many new biomarkers have been characterized for AKI, and these are discussed particularly with their use in known CI-AKI models and studies and include neutrophil gelatinase-associated lipocalin, cystatin C (Cys-C), kidney injury molecule-1, interleukin-18, N-acetyl-β-d-glucosaminidase, and L-type fatty acid-binding protein (L-FABP). The potential of miRNA and metabolomic technology is also mentioned. Early detection of CI-AKI may lead to early intervention and therefore improve patient outcome, and in future any one or a combination of several of these markers together with development in technology for their analysis may prove effective in this respect.

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Section: Diagnosis Of Ci-aki: the Necessity For Novel Biomarkersmentioning

confidence: 99%

Section: Neutrophil Gelatinase-associated Lipocalinmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The potential use of biomarkers in predicting contrast-induced acute kidney injury

Andreucci¹,

Faga²,

Riccio³

et al. 2016

IJNRD

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“…In fact, due to a variety of reasons, serum creatinine is an unreliable marker in diagnosing AKI in patients with ongoing sepsis [11,12]. Certain novel biomarkers may be better predictors of AKI.…”

Section: Detection Of Aki In Sepsismentioning

confidence: 99%

Acute kidney injury in sepsis

Wijayaratne

Wijewickrama

2017

Sri Lanka j Surg

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Sepsis is life-threatening organ dysfunction resulting from a dysregulated host response to infection. It is one of the commonest causes of acute kidney injury (AKI) and is associated with an increase in both morbidity and mortality. Both haemodynamic and non-haemodynamic factors are involved in the pathogenesis of AKI in sepsis. Newer tests are available for the early diagnosis of AKI in septic patients and may provide an opportunity for prevention. The current mainstay of prevention is adequate fluid resuscitation and maintenance of systemic blood pressure, noradrenaline being the vasopressor of choice. Renal replacement therapy may improve outcomes. Continuous renal replacement modalities are preferred in those who are haemodynamically unstable. There is no consensus on the optimal timing or dose of renal replacement therapy.

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Recommendations on Acute Kidney Injury Biomarkers From the Acute Disease Quality Initiative Consensus Conference

et al. 2020

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IMPORTANCE In the last decade, new biomarkers for acute kidney injury (AKI) have been identified and studied in clinical trials. Guidance is needed regarding how best to incorporate them into clinical practice. OBJECTIVE To develop recommendations on AKI biomarkers based on existing data and expert consensus for practicing clinicians and researchers. EVIDENCE REVIEW At the 23rd Acute Disease Quality Initiative meeting, a meeting of 23 international experts in critical care, nephrology, and related specialties, the panel focused on 4 broad areas, as follows: (1) AKI risk assessment; (2) AKI prediction and prevention; (3) AKI diagnosis, etiology, and management; and (4) AKI progression and kidney recovery. A literature search revealed more than 65 000 articles published between 1965 and May 2019. In a modified Delphi process, recommendations and consensus statements were developed based on existing data, with 90% agreement among panel members required for final adoption. Recommendations were graded using the Grading of Recommendations, Assessment, Development and Evaluations system. FINDINGS The panel developed 11 consensus statements for biomarker use and 14 research recommendations. The key suggestions were that a combination of damage and functional biomarkers, along with clinical information, be used to identify high-risk patient groups, improve the diagnostic accuracy of AKI, improve processes of care, and assist the management of AKI. CONCLUSIONS AND RELEVANCE Current evidence from clinical studies supports the use of new biomarkers in prevention and management of AKI. Substantial gaps in knowledge remain, and more research is necessary.

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A basic science view of acute kidney injury biomarkers

Cited by 247 publications

References 122 publications

The potential use of biomarkers in predicting contrast-induced acute kidney injury

The potential use of biomarkers in predicting contrast-induced acute kidney injury

Acute kidney injury in sepsis

Recommendations on Acute Kidney Injury Biomarkers From the Acute Disease Quality Initiative Consensus Conference

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