The biomarkers for acute kidney injury: A clear road ahead?

Abstract

Acute kidney injury (AKI) is a common and serious complication that is associated with several adverse outcomes in hospitalized patients. Serum creatinine is widely used in diagnosing the presence of AKI, but it is a lagging marker of change in kidney function, with poor sensitivity. Thus, different urinary and serum proteins have been intensively investigated as possible biomarkers for early diagnosis of AKI. AKI is a complex process, and biomarkers could be used for different roles at different stages. In addition to facilitating early diagnosis, AKI biomarkers can provide valuable insight into risk stratification for the vulnerable patients. Furthermore, biomarkers could also function as molecular phenotyping tools that could be used to guide clinical intervention. However, the effective use of biomarkers requires an understanding of their strengths, limitations and individual performance characteristics. This manuscript will review the role of a variety of biomarkers in AKI management, and discuss how they can be used in current clinical practice.