New biomarkers in acute kidney injury

Abstract

Acute kidney injury (AKI) is a commonly encountered clinical syndrome. Although it often complicates community acquired illness, it is more common in hospitalized patients, particularly those who are critically ill or who have undergone major surgery. Approximately 20% of hospitalized adult patients develop an AKI during their hospital care, and this rises to nearly 60% in the critically ill, depending on the population being considered. In general, AKI is more common in older adults, in those with preexisting chronic kidney disease and in those with known risk factors for AKI (including diabetes and hypertension). The development of AKI is associated with an increase in both mortality and morbidity, including the development of post-AKI chronic kidney disease. Currently, AKI is defined by a rise in serum creatinine from either a known or derived baseline value and/or oliguria or anuria. However, clinicians may fail to recognize the initial development of AKI because of a delay in the rise of serum creatinine or because of inaccurate urine output monitoring. This, in turn, delays any putative measures to treat AKI or to limit its degree. Consequently, efforts have focused on new biomarkers associated with AKI that may allow early recognition of this syndrome with the intent that this will translate into improved patient outcomes. Here we outline current biomarkers associated with AKI and explore their potential in aiding diagnosis, understanding the pathophysiology and directing therapy.

Keywords:

• Acute kidney injury
• acute kidney disease
• chronic kidney disease
• biomarkers

Disclosure statement

J.L.K has received consulting fees from Astute-Biomerieux, Sphingotec, Pfizer, Baxter, Mallinckrodt, Novartis, Guard Therapeutics, research funding from Astute-Biomerieux Medical, Bioporto, NxStage, Fresenius, Satellite Healthcare, and speaker fees from NxStage medical; L.G.F has received research support and lecture fees from Ortho Clinical Diagnostics, Baxter, Exthera and Biomerieux and consulting fees from La Jolla Pharmaceuticals and Paion. A.R. and A.L. declare no competing interests.

Funding statement

The authors reported that there is no funding associated with the work featured in this article.