Current developments in early diagnosis of acute kidney injury

Springer Science and Business Media LLC - Tập 46 - Trang 1-7 - 2013
Nicholas Obermüller1, Helmut Geiger1, Christine Weipert2, Anja Urbschat3
1 Division of Nephrology, III Medical Clinic, Goethe-University Hospital Frankfurt am Main, Frankfurt, Germany
2Division of Urology and Andrology, Landeskrankenhaus Hall in Tirol, Hall in Tirol, Austria
3Division of Urology and Pediatric Urology, Goethe-University Hospital Frankfurt am Main, Frankfurt, Germany

Tóm tắt

Acute kidney injury (AKI) is a very frequent and serious clinical problem, accounting for overall high morbidity and mortality. Up to date, mortality due to AKI is virtually unchanged over the past 50 years. This may partly be explained due to a delay in initiating renal protective and appropriate therapeutic measures since until now there are no reliable early-detecting biomarkers. The gold standard, serum creatinine, displays poor specificity and sensitivity with regard to identification of the incipient phase of AKI, and this is also true for cystatin C. We aimed to review novel biomarkers of AKI in urine and serum which have now progressed to the clinical phase. The main focus refers to their diagnostic and prognostic value. For this purpose, a web-based literature search using PubMed was performed comprising the following terms: renal failure, acute kidney injury and biomarkers. New molecules such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-d-glucosaminidase (NAG), monocyte chemotactic peptide (MCP-1), Il-18, liver-type fatty acid-binding protein (L-FABP) and Netrin-1 are available and represent promising new markers that, however, need to be further evaluated in the clinical setting for suitability. In clinical settings with incipient AKI, not only the development and the implementation of more sensitive, practicable and accurate biomarkers are required for well-timed treatment initiation. Just as important is a substantial improvement of refined and applicable prophylactic therapeutic options in these situations. Before full adoption in clinical practice can be accomplished, adequately powered clinical trials testing a row of biomarkers are strongly warranted.

Tài liệu tham khảo

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