scholarly journals Current Status of Novel Biomarkers for the Diagnosis of Acute Kidney Injury: A Historical Perspective

2019 ◽  
Vol 35 (5) ◽  
pp. 415-424 ◽  
Author(s):  
Benjamin R. Griffin ◽  
Katja M. Gist ◽  
Sarah Faubel
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Structural Damage ◽  
Medical Condition ◽  
Kidney Injury ◽  
Cost Of Care ◽  
Current Status ◽  
Short Period ◽  
Novel Biomarkers ◽  
New Biomarkers

Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the prevention and treatment of the disease. A lack of efficacy in drug trials led to the concern that AKI was not being diagnosed early enough for an effective intervention and that a rise in serum creatinine itself is not a sensitive-enough marker. Researchers have been searching for novel biomarkers that can not only assess a decline in kidney function but also demonstrate structural damage to the kidney and at time points earlier than increases in serum creatinine measurements allow. Over the past 10 years, there have been 3300 new publications and hundreds of new biomarkers investigated, yet concern still remains regarding AKI biomarker performance. The AKI biomarkers are yet to be widely utilized in clinical practice, leading some to question whether AKI biomarkers will ever reach their initial promise. However, we believe that biomarkers are an important part of current and future AKI research and clinical management. In this review, we compare the historical contexts of acute myocardial ischemia and AKI biomarker development to illustrate the progress that has been made within AKI biomarker research in a relatively short period of time and also to point out key differences between the disease processes that have been barriers to widespread AKI biomarker adoption. Finally, we discuss potential paths by which biomarkers can lead to appropriate AKI treatment responses that lower morbidity and mortality.

scholarly journals New Biomarkers for the Quick Detection of Acute Kidney Injury

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Abdulmuttalip Simsek ◽  
Volkan Tugcu ◽  
Ali Ihsan Tasci
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Clinical Training ◽  
Kidney Injury ◽  
Urinary Proteins ◽  
New Biomarkers ◽  
Urine And Serum

Acute kidney injury (AKI) is a common and strong problem in the diagnosis of which based on measurement of BUN and serum creatinine. These traditional methods are not sensitive and specific for the diagnosis of AKI. AKI is associated with increased morbidity and mortality in critically ill patients and a quick detection is impossible with BUN and serum creatinine. A number of serum and urinary proteins have been identified that may messenger AKI prior to a rise in BUN and serum creatinine. New biomarkers of AKI, including NGAL, KIM-1, cystatin-C, IL-18, and L-FABP, are more favourable tests than creatinine which have been identified and studied in several experimental and clinical training. This paper will discuss some of these new biomarkers and their potential as useful signs of AKI. We searched the literature using PubMed and MEDLINE with acute kidney injury, urine, and serum new biomarkers and the articles were selected only from publication types in English.

scholarly journals Biomarkers of acute kidney disease. potential application in practice

2021 ◽  
Vol 23 (1) ◽  
pp. 15-19
Author(s):  
Ekaterina S. Schelkanovtseva ◽  
◽  
Ekaterina S. Schelkanovtseva ◽  
Olga Iu. Mironova ◽  
Viktor V. Fomin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Potential Application ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Acute Kidney Disease ◽  
Definition Of ◽  
New Biomarkers

Acute kidney injury (AKI) is a common clinical syndrome. Its variety of presentation explains the absence of “kidney troponin”. Many research projects of new biomarkers are ongoing now. The enormous number of biomarkers has been identified already. It makes difficult to choose the correct test and dictates the importance of the fastest and most accurate introduction of AKI biomarkers into clinical practice. The integration of appropriately selected biomarkers in routine clinical practice for high-risk patients of AKI is very important. Currently, serum creatinine (sCr) and urine output are used to define AKI in accordance with the definition of KDIGO (Kidney Disease: Improving Global Outcomes), which have a number of significant limitations for practitioners, including the inability to diagnose AKI before serum creatinine levels increase. Practitioners need systematic information about the latest AKI markers and possible situations, when and for which patient groups they can be used. This is the main goal of our review. Keywords: acute kidney injury, biomarkers, NGAL, TIMP-2, IGFBP7, cystatin C, markers, injury, kidney stress For citation: Schelkanovtseva ES, Mironova OIu, Fomin VV. Biomarkers of acute kidney disease. Potential application in practice. Consilium Medicum. 2021; 23 (1): 15–19. DOI: 10.26442/20751753.2021.1.200729

scholarly journals The need for disruptive innovation in acute kidney injury

2020 ◽  
Vol 24 (11) ◽  
pp. 979-988
Author(s):  
Kent Doi
Keyword(s):  
Acute Kidney Injury ◽  
Medical Condition ◽  
Kidney Injury ◽  
Basic Research ◽  
Disruptive Innovation ◽  
Multiple Organ ◽  
Organ Crosstalk ◽  
Research Findings ◽  
Poor Outcomes ◽  
New Biomarkers

Abstract Acute kidney injury (AKI) is a threatening medical condition associated with poor outcomes at different settings. The development of standardized diagnostic criteria and new biomarkers addressed significant clinical impacts of AKI and the need for an early AKI detection, respectively. There have been some breakthroughs in understanding the pathogenesis of AKI through basic research; however, treatments against AKI aside from renal replacement therapy (RRT) have not shown adequate successful results. Biomarkers that could identify good responders to certain treatment are expected to facilitate translation of basic research findings. Most patients with severe AKI treated with RRT died due to multiple-organ failure, not renal dysfunction. Hence, it is essential to identify other organ dysfunctions induced by AKI as organ crosstalk. Also, a multidisciplinary approach of critical care nephrology is needed to evaluate a complex organ crosstalk in AKI. For disruptive innovation for AKI, we further explore these new aspects of AKI, which previously were considered outside the scope of nephrology.

scholarly journals Biomarkers of Acute Kidney Injury

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Jeffrey C. Sirota ◽  
Jelena Klawitter ◽  
Charles L. Edelstein
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Outpatient Setting ◽  
Clinical Settings ◽  
Chemical Exposures ◽  
Test Characteristics ◽  
New Biomarkers

Acute kidney injury (AKI) is a common problem in both the inpatient and outpatient setting and often results from drug toxicities. Traditional methods of identifying AKI, through measurement of blood urea nitrogen and serum creatinine, are problematic in that they are slow to detect decreases in glomerular filtration rate (GFR) and are influenced by a variety of factors that are not related to GFR changes. The problems inherent in a creatinine-based diagnosis of AKI have impeded the development of proper therapeutics in AKI and posed problems in evaluating nephrotoxicity of drugs and other chemical exposures. In recent years, a number of new biomarkers of AKI with more favorable test characteristics than creatinine have been identified and studied in a variety of experimental and clinical settings. This review will consider the most well-established biomarkers and appraise the literature, with particular attention given to the use of biomarkers in identifying toxin-mediated AKI.

scholarly journals Advances and Challenges on New Therapies and Clinical Targets of Acute Kidney Injury

2018 ◽  
Vol 46 (8) ◽  
pp. 925-929 ◽  
Author(s):  
Rima Kang ◽  
Brad Rovin
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
High Risk ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
High Morbidity ◽  
Preventative Measures ◽  
Urine Biomarkers ◽  
New Biomarkers ◽  
Pathophysiologic Mechanisms

Acute kidney injury (AKI) is encountered in high-risk hospital settings where patients often suffer systemic illnesses, undergo surgery, or receive medications toxic to the kidneys. It is associated with high morbidity and mortality. Despite advances in understanding the pathophysiologic mechanisms involved in AKI, our ability to detect AKI early is limited, and outcomes remain unchanged. Once AKI is identified by the traditional markers of urine output and serum creatinine, the main therapeutic intervention is usually supportive care and/or renal replacement therapy until renal injury resolves. Urine biomarkers provide an optimistic future, offering the ability to identify patients at high risk for AKI such that preventative measures can be introduced. In this article, the etiologies of AKI are discussed, new biomarkers are assessed, and areas for further investigation are suggested.

scholarly journals Role of New Biomarkers: Functional and Structural Damage

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Evdoxia Tsigou ◽  
Vasiliki Psallida ◽  
Christos Demponeras ◽  
Eleni Boutzouka ◽  
George Baltopoulos
Keyword(s):  
Structural Damage ◽  
Delayed Diagnosis ◽  
Kidney Injury ◽  
Current Status ◽  
Critically Ill Patient ◽  
Fatty Acid Binding ◽  
Prolonged Length ◽  
Genomics And Proteomics ◽  
New Biomarkers ◽  
Kidney Injury Molecule 1

Traditional diagnosis of acute kidney injury (AKI) depends on detection of oliguria and rise of serum creatinine level, which is an unreliable and delayed marker of kidney damage. Delayed diagnosis of AKI in the critically ill patient is related to increased morbidity and mortality, prolonged length of stay, and cost escalation. The discovery of a reliable biomarker for early diagnosis of AKI would be very helpful in facilitating early intervention, evaluating the effectiveness of therapy, and eventually reducing cost and improving outcome. Innovative technologies such as genomics and proteomics have contributed to the discovery of new biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys C), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and liver-type fatty acid binding protein (L-FABP). The current status of the most promising of these novel AKI biomarkers, including NGAL, Cys C, KIM-1, L-FABP, and IL-18, is reviewed.

scholarly journals Perioperative use of serum creatinine and postoperative acute kidney injury: a single-centre, observational retrospective study to explore physicians’ perception and practice

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
High Risk ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Malignant Disease ◽  
Kidney Injury ◽  
Major Surgery ◽  
Single Centre

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.

The Effect of a Short Course of Tocolytic Indomethacin on Urinary Biomarkers in Premature Infants

2021 ◽  
Author(s):  
Ahmad El Samra ◽  
Ayesa Mian ◽  
Marc Lande ◽  
Hongyue Wang ◽  
Ronnie Guillet
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Urinary Biomarkers ◽  
Bivariate Analysis ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Short Course ◽  
Medication Exposure ◽  
Epidermal Growth ◽  
Neutrophil Gelatinase

Objective The aim of this study was to determine the effects of a 2-day prenatal course of indomethacin on the premature kidney as reflected by serum creatinine and urinary biomarkers. Study Design Urine of infants ≤ 32 weeks was collected for the first 14 days and analyzed for cystatin C, neutrophil gelatinase-associated lipocalin, osteopontin, β2 microglobulin, epidermal growth factor, uromodulin, and microalbumin. Bivariate analysis compared serum creatinine and biomarkers of exposed (INDO) and unexposed (CONT) subjects. Results Fifty-seven infants (35 CONT and 22 INDO) were studied. The cohorts were similar in gestational age, birthweight, race, gender, nephrotoxic medication exposure, and Apgar scores. CONT had more dopamine exposure and included more pre-eclamptic mothers (p = 0.005). No difference in creatinine-based acute kidney injury or the log transformed mean, maximum, and minimum values of urinary biomarkers was detected. Conclusion Our findings suggest that a short course of tocolytic indomethacin does not result in neonatal acute kidney injury. Key Points

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