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Acute Kidney Injury: the role of biomarkers for early diagnosis

Sérgio Mina Gaião, José Artur Osório de Carvalho Paiva
Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery...
July 2017: Revista Brasileira de Terapia Intensiva
Lynn Redahan, Patrick T Murray
PURPOSE OF REVIEW: Drug-induced kidney injury (DIKI) is an important and potentially modifiable cause of acute kidney injury (AKI). The reliance on traditional markers of kidney injury to diagnose DIKI impedes early detection. Biomarkers of DIKI that facilitate early diagnosis and the identification of high-risk patients are essential to ameliorate the clinical burden of this complication. RECENT FINDINGS: Recent progress in this area supports the potential utility of several biomarkers for the diagnosis of DIKI, for the prediction of outcomes and also for monitoring responses to potential nephrotoxic or beneficial therapies...
December 2017: Current Opinion in Critical Care
Maya Sterling, Zubaida Al-Ismaili, Kelly R McMahon, Melissa Piccioni, Michael Pizzi, Theresa Mottes, Larry C Lands, Sharon Abish, Adam J Fleming, Michael R Bennett, Ana Palijan, Prasad Devarajan, Stuart L Goldstein, Maureen M O'Brien, Michael Zappitelli
BACKGROUND: Cisplatin (Cis), carboplatin (Carb), and ifosfamide (Ifos) are common nephrotoxic chemotherapies. Biomarkers of tubular injury may allow for early acute kidney injury (AKI) diagnosis. PROCEDURE: We performed a two-center (Canada, United States) pilot study to prospectively measure serum creatinine (SCr), urine neutrophil gelatinase-associated lipocalin (NGAL), and interleukin-18 (IL-18) in children receiving Cis/Carb (27 episodes), Ifos (30 episodes), and in 15 hospitalized, nonchemotherapy patients...
October 2017: Pediatric Blood & Cancer
Rinaldo Bellomo, John A Kellum, Claudio Ronco, Ron Wald, Johan Martensson, Matthew Maiden, Sean M Bagshaw, Neil J Glassford, Yugeesh Lankadeva, Suvi T Vaara, Antoine Schneider
Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such AKI. Its pathophysiology remains poorly understood, but animal models and lack of histological changes suggest that, at least initially, septic AKI may be a functional phenomenon with combined microvascular shunting and tubular cell stress. The diagnosis remains based on clinical assessment and measurement of urinary output and serum creatinine...
June 2017: Intensive Care Medicine
Xun Hu, Xiao-Dong Zhuang, Yi Li, Fei-Fei Li, Yue Guo, Zhi-Min Du, Xin-Xue Liao
Contrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired acute kidney injury (AKI). Emerging evidence has revealed that soluble klotho (sklotho) could be a novel biomarker for early AKI diagnosis. The aims of this study were to assess the predictive role of sklotho for CIN and to develop a prediction nomogram in patients undergoing percutaneous coronary intervention (PCI). This study is registered on (NCT 02650336).Patients aged 18 years or older undergoing planned PCI were prospectively recruited between May 2014 and July 2015...
April 6, 2017: International Heart Journal
Zeki Toprak, Egemen Cebeci, Serife Aysen Helvaci, Ilkim Deniz Toprak, Yasin Kutlu, Abdullah Sakin, Tufan Tukek
PURPOSE: Cisplatin is a chemotherapeutic agent with potential nephrotoxicity. Delayed increase in serum creatinine after cisplatin administration shows that serum creatinine may not be a sufficient marker for early detection of nephrotoxicity. Urinary insulin-like growth factor binding protein-7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2) which are cell-cycle arrest biomarkers have been proposed recently for early detection of acute kidney injury (AKI). Herein, we evaluated urinary TIMP-2/IGFBP7 levels before and after cisplatin administration to patients with lung cancer and their role was examined in the early diagnosis of AKI...
June 2017: International Urology and Nephrology
Jorien De Loor, Ingrid Herck, Katrien Francois, Astrid Van Wesemael, Lieve Nuytinck, Evelyne Meyer, Eric A J Hoste
BACKGROUND: A common and serious complication of cardiac surgery prompting early detection and intervention is cardiac surgery-associated acute kidney injury (CSA-AKI). Urinary chitinase 3-like protein 1 (UCHI3L1) was found to predict AKI associated with critical illness in adults. Our aims were therefore to evaluate whether UCHI3L1 can also be used to predict AKI associated with elective cardiac surgery in adults, and to compare this predictive ability with that of urinary neutrophil gelatinase-associated lipocalin (UNGAL), more frequently assessed early serum creatinine (SCr) measurements, and various two-biomarker panels...
December 2017: Annals of Intensive Care
Xiaoqin Liu, Yi Guan, Sheng Xu, Qingzhao Li, Yuanbo Sun, Ruijie Han, Chunyang Jiang
Accompanied with the broad application of interventional therapy, the incidence of acute kidney injury (AKI) has been recently increasing in clinical renal medicine. The pathogenesis of AKI is diverse and complex. In the context of the requirements for the diagnosis and treatment of a renal disorder, a large number of studies have explored biological markers and their usefulness to the early diagnosis and treatment of AKI, including glomerular injury, renal tubular injury, and others. These biomarkers provide an important basis for early monitoring of AKI, but are still not quite sufficient...
2016: Kidney & Blood Pressure Research
Wei-Gang Wang, Wei-Xia Sun, Bao-Shan Gao, Xin Lian, Hong-Lan Zhou
The current lack of complete understanding of the pathogenesis of acute kidney injury (AKI) is a significant barrier to its early diagnosis and treatment. Cell cycle arrest plays an important role in the protection of renal tubular epithelial cells and maladaptive repair following AKI. G1 phase cell arrest serves as a protective mechanism following AKI, avoiding replication of damaged DNA. Insulinlike growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinase-2 (TIMP-2) are closely associated with G1 cell cycle arrest during the very early phase of cellular damage and can serve as an ideal biomarker to predict AKI...
2017: Current Protein & Peptide Science
Murthy Yerramilli, Giosi Farace, John Quinn, Maha Yerramilli
Chronic kidney disease (CKD) and acute kidney injury (AKI) are interconnected and the presence of one is a risk for the other. CKD is an important predictor of AKI after exposure to nephrotoxic drugs or major surgery, whereas persistent or repetitive injury could result in the progression of CKD. This brings new perspectives to the diagnosis and monitoring of kidney diseases highlighting the need for a panel of kidney-specific biomarkers that reflect functional as well as structural damage and recovery, predict potential risk and provide prognosis...
November 2016: Veterinary Clinics of North America. Small Animal Practice
Prasad Devarajan, John Lynn Jefferies
The incidence of chronic kidney disease (CKD) in children and adults is increasing. Cardiologists have become indispensable members of the care provider team for children with CKD. This is partly due to the high incidence of CKD in children and adults with congenital heart disease, with current estimates of 30-50%. In addition, the high incidence of acute kidney injury (AKI) due to cardiac dysfunction or following pediatric cardiac surgery that may progress to CKD is also well documented. It is now apparent that AKI and CKD are uniquely intertwined as interconnected syndromes...
June 2016: Progress in Pediatric Cardiology
Müge Aydoğdu, Nazlıhan Boyacı, Seher Yüksel, Gül Gürsel, Ayşe Banu Çaycı Sivri
AIM: An ideal biomarker for early diagnosis of septic acute kidney injury (AKI) should reflect renal stress or damage at initiation point, at cellular level. The aim of this study was to assess the role of a urinary cell cycle arrest marker, insulin-like growth factor-binding protein 7 (IGFBP7) in early diagnosis of septic AKI in adult critical care patients. METHODS: This was a single-center prospective cohort study. Patients without AKI, admitted to a medical intensive care unit (ICU) between January 2010 and March 2013, were included...
September 2016: Scandinavian Journal of Clinical and Laboratory Investigation
Mira Pavkovic, Vishal S Vaidya
Drug-induced kidney injury (DIKI) is a severe complication in hospitalized patients associated with higher probabilities of developing progressive chronic kidney disease or end-stage renal diseases. Furthermore, DIKI is a problem during preclinical and clinical phases of drug development leading to high rates of project terminations. Understanding the molecular perturbations caused by DIKI would pave the way for a new class of therapeutics to mitigate the damage. Yet, another approach to ameliorate DIKI is identifying sensitive and specific translational biomarkers that outperform the current diagnostic analytes like serum creatinine and facilitate early diagnosis...
July 2016: Pharmacology & Therapeutics
Mehmet Yekta Oncel, Fuat Emre Canpolat, Sema Arayici, Evrim Alyamac Dizdar, Nurdan Uras, Serife Suna Oguz
BACKGROUND: Acute kidney injury (AKI) affects up to 60% of severely asphyxiated neonates. The diagnosis of AKI can be and is further challenged by a lack of good biomarkers. We studied the role of novel markers for AKI, neutrophil gelatinase-associated lipocalin (NGAL), interleukin-8 (IL-18), Netrin-1 (NTN-1), and sodium hydrogen exchanger isoform 3 (NHE3) on development and early diagnosis of AKI in newborns with perinatal asphyxia (PA). METHODS: Forty-one newborns with a diagnosis of PA (15 with AKI and 26 without AKI) and 20 healthy matched controls were involved to the study...
July 2016: Renal Failure
Ji Hyun Cheon, Sun Young Kim, Ji Yeon Son, Ye Rim Kang, Ji Hye An, Ji Hoon Kwon, Ho Sub Song, Aree Moon, Byung Mu Lee, Hyung Sik Kim
The identification of biomarkers for the early detection of acute kidney injury (AKI) is clinically important. Acute kidney injury (AKI) in critically ill patients is closely associated with increased morbidity and mortality. Conventional biomarkers, such as serum creatinine (SCr) and blood urea nitrogen (BUN), are frequently used to diagnose AKI. However, these biomarkers increase only after significant structural damage has occurred. Recent efforts have focused on identification and validation of new noninvasive biomarkers for the early detection of AKI, prior to extensive structural damage...
January 2016: Toxicological Research
Anitha Vijayan, Sarah Faubel, David J Askenazi, Jorge Cerda, William H Fissell, Michael Heung, Benjamin D Humphreys, Jay L Koyner, Kathleen D Liu, Girish Mour, Thomas D Nolin, Azra Bihorac
Acute kidney injury (AKI) is a serious complication, commonly occurring in the critically ill population, with devastating short- and long-term consequences. Despite standardization of the definition and staging of AKI, early recognition remains challenging given that serum creatinine level is a marker, albeit imperfect, of kidney function and not kidney injury. Furthermore, the delay in increase in serum creatinine level after loss of glomerular filtration also prevents timely detection of decreased kidney function in patients with AKI...
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Branislava Medić, Branislav Rovcanin, Katarina Savic Vujovic, Danilo Obradovic, Dusan Duric, Milica Prostran
Despite the recent findings concerning pathogenesis and novel therapeutic strategies, the mortality rate in patients with acute kidney injury (AKI) remains very high. Early detection of patients with impaired renal function may help to ensure more aggresive treatment and to improve clinical outcome. Serum creatinine is still gold standard of kidney injury, although it is well known as an insensitive and unreliable biomarker (for example, its concentration does not increase significantly until about half of the kidney function is lost)...
2016: Current Medicinal Chemistry
Nattachai Srisawat, Kearkiat Praditpornsilpa, Kanitha Patarakul, Malee Techapornrung, Tinnapop Daraswang, Theerapon Sukmark, Kamol Khositrangsikun, Apinya Fakthongyoo, Petchdee Oranrigsupak, Laksamon Praderm, Ummarit Suwattanasilpa, Sadudee Peerapornratana, Passisd Loahaveeravat, Nattachai Suwachittanont, Thaksa-on Wirotwan, Chayanat Phonork, Sarinya Kumpunya, Khajohn Tiranathanagul, Chintana Chirathaworn, Somchai Eiam-ong, Kriang Tungsanga, Visith Sitprija, John A Kellum, Natavudh Townamchai
AKI is one of the most serious complications of leptospirosis, an important zoonosis in the tropics. Recently, NGAL, one of the novel AKI biomarkers, is extensively studied in various specific settings such as sepsis, cardiac surgery, and radiocontrast nephropathy. In this multicenter study, we aimed to study the role of NGAL as an early marker and an outcome predictor of leptospirosis associated AKI. Patients who presented with clinical suspiciousness of leptospirosis were prospectively enrolled in 9 centers from August 2012 to November 2014...
2015: PloS One
M R Khatami, M R P Sabbagh, N Nikravan, Z Khazaeipour, M A Boroumand, S Sadeghian, B Davoudi
Neutrophil-gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury. The aim of this study was to define a cut-off for NGAL in the early diagnosis of contrast-induced nephropathy (CIN) in patients with normal kidney function. We enrolled 121 patients with normal serum creatinine who underwent coronary angiography. NGAL was measured in urine before the procedure and 12 and 24 h afterward. CIN was defined as a 0.3 mg/dl increase in serum creatinine within 48 h after the procedure. Seven of 121 patients had CIN (5...
September 2015: Indian Journal of Nephrology
A Gutiérrez-Escolano, E Santacruz-Vázquez, F Gómez-Pérez
BACKGROUND: Contrast-induced nephropathy (CIN) is a complex syndrome of acute nephropathy that occurs following infusion of intravascular contrast agents, and is associated with an increased risk for adverse cardiovascular events. While there is no ideal biomarker for making an early diagnosis of CIN, we hypothesized that levels of specific circulating microRNA (miRNA) species might serve such a role. METHODS: miRNA microarray assays were used to detect miRNAs in the kidney tissue of rats studied as an animal model of CIN...
2015: Renal Failure
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