Journal
CURRENT OPINION IN PEDIATRICS
Volume 23, Issue 2, Pages 194-200Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOP.0b013e328343f4dd
Keywords
acute kidney injury; acute renal failure; biomarker; interleukin-18; kidney injury molecule-1; liver-type fatty acid binding protein; neutrophil gelatinase-associated lipocalin
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Funding
- NIH [R01 DK53289, RO1 DK069749, R21 DK070163]
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Purpose of review Acute kidney injury (AKI) is a common and serious condition, the diagnosis of which depends on serum creatinine, which is a delayed and unreliable indicator of AKI. Fortunately, understanding the early stress response of the kidney to acute injuries has revealed a number of potential biomarkers. The current status of the most promising of these novel AKI biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (L-FABP), and interleukin (IL)-18, is reviewed. Recent findings In particular, NGAL is emerging as an excellent biomarker in the urine and plasma, for the early prediction of AKI, for monitoring clinical trials in AKI, and for the prognosis of AKI in several common clinical scenarios. However, biomarker combinations may be required to improve our ability to predict AKI and its outcomes in a context-specific manner. Summary It is vital that additional large future studies demonstrate the association between biomarkers and hard clinical outcomes independent of serum creatinine concentrations and that randomization to a treatment for AKI based on high biomarker levels results in an improvement in clinical outcomes.
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