Acute kidney injury biomarkers: renal angina and the need for a renal troponin IReport as inadecuate

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BMC Medicine

, 9:135

Clinical biomarkers


Acute kidney injury AKI in hospitalized patients is independently associated with increased morbidity and mortality in pediatric and adult populations. Continued reliance on serum creatinine and urine output to diagnose AKI has resulted in our inability to provide successful therapeutic and supportive interventions to prevent and mitigate AKI and its effects. Research efforts over the last decade have focused on the discovery and validation of novel urinary biomarkers to detect AKI prior to a change in kidney function and to aid in the differential diagnosis of AKI. The aim of this article is to review the AKI biomarker literature with a focus on the context in which they should serve to add to the clinical context facing physicians caring for patients with, or at-risk for, AKI. The optimal and appropriate utilization of AKI biomarkers will only be realized by understanding their characteristics and placing reasonable expectations on their performance in the clinical arena.

AbbreviationsAKIacute kidney injury

ATNacute tubular necrosis

BNPbrain natiuretic peptide

CKDchronic kidney disease

CPBcardiopulmonary bypass

CPKcreatine phosphokinase

CRRTcontinuous renal replacement therapy

eGFRestimated glomerular filtration rate

HUShemolytic uremic syndrome


KIM-1kidney injury molecule-1

L-FABPliver-type fatty acid binding protein

NGALneutrophil gelatinase-associated lipocalin


injuryfailure, loss, end-stage kidney disease

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Author: Stuart L Goldstein


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