Biomarkers for AKI improve clinical practice: no

Ostermann, Marlies; Joannidis, Michael

doi:10.1007/s00134-014-3540-0

Cited by 40 publications

(21 citation statements)

References 20 publications

(27 reference statements)

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“…However, the utility of oliguria as a predictor of acute kidney injury (AKI) in hospitalized patients is limited by its relative sensitivity but poor specificity [2,3]. To improve both the prediction of, and diagnosis of AKI, several biomarkers have been described over the last 2 decades reflecting functional impairment or tubular damage [4,5,6]. One would assume that any observed biomarker signal and the urinary output are intimately linked and this review is intended to elucidate the relationship between the two.…”

Section: Introductionmentioning

confidence: 99%

Oliguria and Biomarkers of Acute Kidney Injury: Star Struck Lovers or Strangers in the Night?

Lehner

Forni

Joannidis

2016

Nephron

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Oliguria is a common phenomenon that is found in hospitalized patients . Although a rapid reduction in urine excretion rate may reflect a precipitous fall in the glomerular filtration rate, in many cases it may not. Given the common physiological finding of oliguria, we explore the relationship between the functional biomarker of renal injury (oliguria) with the increasing number of markers of renal injury to see if this combination may aid in risk stratification.

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Section: Introductionmentioning

confidence: 99%

Oliguria and Biomarkers of Acute Kidney Injury: Star Struck Lovers or Strangers in the Night?

Lehner

Forni

Joannidis

2016

Nephron

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“…It is sufficient to say that many biomarkers reflect a general degree of severity of disease, rather than being specific for kidney injury, or suffer from difficulties in the analytic methodology [48]. Furthermore, biomarker studies vary in their cut-offs between positive and negative results [49]. As a result, potential harm may occur if important interventions (i.e., computed tomography with contrast or necessary administration of aminoglycosides) are delayed or withheld based on false positive biomarker results.…”

Section: Novel Biomarkersmentioning

confidence: 99%

Epidemiology of acute kidney injury in children worldwide, including developing countries

2016

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In this review we summarize the world-wide epidemiology of acute kidney injury (AKI) in children with special emphasis on low-income countries, notably those of the sub-Saharan continent. We discuss definitions and classification systems used in pediatric AKI literature. At present, despite some shortcomings, traditional Pediatric Risk Injury Failure Loss and End Stage Kidney Disease (pRIFLE) and Kidney Disease Improving Global Outcomes (KDIGO) systems are the most clinically useful. Alternative definitions, such as monitoring serum cystatin or novel urinary biomarkers, including cell cycle inhibitors, require more long-term studies in heterogenous pediatric AKI populations before they can be recommended in routine clinical practice. A potentially interesting future application of some novel biomarkers could be incorporation into the "renal angina index", a concept recently introduced in pediatric nephrology. The most reliable epidemiological data on AKI in children come from high-outcome countries and are frequently focused on critically ill pediatric intensive care unit populations. In these patients AKI is often secondary to other systemic illnesses or their treatment. Based on a recent literature search performed within the framework of the "AKI 0by25" project of the International Society of Nephrology, we discuss the scarce and often inaccurate data on AKI epidemiology in low-income countries, notably those on the African continent. The last section reflects on some of the many barriers to improvement of overall health care in low-income populations. Although preventive strategies for AKI in low-income countries should essentially be the same as those in high-income countries, we believe any intervention for earlier detection and better treatment of AKI must address all health determinants, including educational, cultural, socio-economic and environmental factors, specific for these deprived areas.

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“…before alterations in traditional markers occur), enable differential diagnosis, stratify patients based on prognosis (progression, need for renal replacement therapy, recovery, survival) and to monitor the response to interventions and treatment. The integration of novel biomarkers into clinical practice should enable incremental diagnostic and prognostic information beyond that found by clinical evaluation or traditional markers alone (5,7). Numerous different urinary and serum proteins, molecules and -most recently -micro RNAs have been rigorously investigated during the last decade.…”

Section: Novel Biomarkers Of Akimentioning

confidence: 99%

Cell cycle arrest biomarkers for the early prediction of acute kidney injury - full of promise, but not a must–have for yet

Schiffl¹

2016

J Renal Inj Prev

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Biomarkers for AKI improve clinical practice: no

Cited by 40 publications

References 20 publications

Oliguria and Biomarkers of Acute Kidney Injury: Star Struck Lovers or Strangers in the Night?

Oliguria and Biomarkers of Acute Kidney Injury: Star Struck Lovers or Strangers in the Night?

Epidemiology of acute kidney injury in children worldwide, including developing countries

Cell cycle arrest biomarkers for the early prediction of acute kidney injury - full of promise, but not a must–have for yet

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