Biomarkers for the diagnosis of acute kidney injury
- 1 November 2007
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Nephrology and Hypertension
- Vol. 16 (6), 557-564
- https://doi.org/10.1097/mnh.0b013e3282f08745
Abstract
The identification of acute kidney injury relies on tests like blood urea nitrogen and serum creatinine that were identified and incorporated into clinical practice several decades ago. This review summarizes clinical studies of newer biomarkers that may permit earlier and more accurate identification of acute kidney injury. The urine may contain sensitive and specific markers of kidney injury that are present due to either impaired tubular reabsorption and catabolism of filtered molecules or release of tubular cell proteins in response to ischemic or nephrotoxic injury. Many potential markers have been studied. Promising injury markers in the urine include N-acetyl-beta-D-glucosaminidase, neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, and interleukin-18. Serum cystatin C may be a better measure of glomerular filtration rate than serum creatinine or blood urea nitrogen. New biomarkers of kidney injury and glomerular filtration rate hold the promise of substantially improving the diagnostic approach to acute kidney injury. Adequately powered clinical studies of multiple biomarkers are needed to qualify the biomarkers before they can be fully adopted in clinical practice. Once adopted, more sensitive biomarkers of acute kidney injury hold the potential to transform the care of patients with renal disease.Keywords
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