Biomarkers of AKI: a review of mechanistic relevance and potential therapeutic implications

AKI is a common clinical condition associated with a number of adverse outcomes. More timely diagnosis would allow for earlier intervention and could improve patient outcomes. The goal of early identification of AKI has been the primary impetus for AKI biomarker research, and has led to the discover...

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Published inClinical journal of the American Society of Nephrology Vol. 10; no. 1; pp. 147 - 155
Main Authors Alge, Joseph L, Arthur, John M
Format Journal Article
LanguageEnglish
Published United States American Society of Nephrology 01.01.2015
Subjects
Acute Kidney Injury - diagnosis
Acute Kidney Injury - metabolism
Acute Kidney Injury - physiopathology
Acute Kidney Injury - therapy
Animals
Biomarkers - metabolism
Humans
In-Depth Review
Predictive Value of Tests
Prognosis
renin-angiotensin system
acute renal failure
pathophysiology of renal disease and progression
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Summary:AKI is a common clinical condition associated with a number of adverse outcomes. More timely diagnosis would allow for earlier intervention and could improve patient outcomes. The goal of early identification of AKI has been the primary impetus for AKI biomarker research, and has led to the discovery of numerous novel biomarkers. However, in addition to facilitating more timely intervention, AKI biomarkers can provide valuable insight into the molecular mechanisms of this complex and heterogeneous disease. Furthermore, AKI biomarkers could also function as molecular phenotyping tools that could be used to direct clinical intervention. This review highlights the major studies that have characterized the diagnostic and prognostic predictive power of these biomarkers. The mechanistic relevance of neutrophil gelatinase-associated lipocalin, kidney injury molecule 1, IL-18, liver-type fatty acid-binding protein, angiotensinogen, tissue inhibitor of metalloproteinase-2, and IGF-binding protein 7 to the pathogenesis and pathobiology of AKI is discussed, putting these biomarkers in the context of the progressive phases of AKI. A biomarker-integrated model of AKI is proposed, which summarizes the current state of knowledge regarding the roles of these biomarkers and the molecular and cellular biology of AKI.
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ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.12191213