Biomarkers in acute kidney injury: Evidence or paradigm?

• Published in: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia Vol. 36; no. 4; p. 339
• Main Authors: Lombi, Fernando, Muryan, Alexis, Canzonieri, Romina, Trimarchi, Hernán
• Format: Journal Article
• Language: English
• Published: Spain 01.07.2016
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - diagnosis; Acute Kidney Injury - therapy; Acute Kidney Injury - urine; Biomarkers - blood; Biomarkers - urine; Blood Chemical Analysis - instrumentation; Cell Cycle Checkpoints; Clinical Trials as Topic; Critical Illness; Cystatin C - blood; Early Diagnosis; Evidence-Based Medicine; Hepatitis A Virus Cellular Receptor 1 - blood; Humans; Interleukin-18 - blood; Interleukin-18 - urine; Lipocalin-2 - blood; Multicenter Studies as Topic; Neoplasm Proteins - urine; Oliguria - etiology; Renal Replacement Therapy; Biomarkers; Biomarcadores; Lesión renal aguda; Acute kidney injury
• DOI: 10.1016/j.nefro.2016.01.012

Acute kidney injury in the critically ill represents an independent risk factor of morbidity and mortality in the short and long terms, with significant economic impacts in terms of public health costs. Currently its diagnosis is still based on the presence of oliguria and/or a gradual increase in serum creatinine, which make the diagnosis a delayed event and to detriment of the so-called 'therapeutic window'. The appearance of new biomarkers of acute kidney injury could potentially improve this situation, contributing to the detection of 'subclinical acute kidney injury', which could allow the precocious employment of multiple treatment strategies in order to preserve kidney function. However these new biomarkers display sensitive features that may threaten their full capacity of action, which focus specifically on their additional contribution in the early approach of the situation, given the lack of specific validated treatments for acute kidney injury. This review aims to analyze the strengths and weaknesses of these new tools in the early management of acute kidney injury.