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Acute Nephrology for the Critical Care Physician pp 111–123Cite as

Acute Kidney Injury Biomarkers

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Abstract

Acute kidney injury (AKI) is defined by a rise in serum creatinine, fall in urine output or both. Numerous new biomarkers of AKI have been identified and validated in different experimental and clinical scenarios with the aims of overcoming some of the short-comings of serum creatinine, improving the management of patients with AKI and advancing our understanding of AKI. The most studied biomarkers are neutrophil gelatinase-associated lipocalin, cystatin C, Kidney Injury Molecule 1 and Interleukin 18. Studies have shown that some biomarkers are able to indicate AKI before a detectable serum creatinine rise, in particular after surgery or following coronary angiography but also in patients presenting to the emergency department and on admission to the Intensive Care Unit. Other studies demonstrated that biomarker levels correlated with severity of AKI and were predictive of renal recovery, need for renal replacement therapy or mortality. However, the results have been conflicting and confounded. While new biomarkers appear to perform in the research setting, their role in routine clinical practice is influenced by patient case mix, comorbidities, aetiology of AKI, timing of renal insult, timing of biomarker measurement and the selected thresholds for diagnosis. Furthermore, evidence that the use of novel biomarkers results in better patient outcomes is still lacking.

More work is necessary to identify those who benefit most from measuring either an individual biomarker or a panel of different markers. Finally, studies confirming that the use of biomarkers influences decision-making and improves outcomes are still awaited.

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Author information

Authors and Affiliations

  1. Department of Critical Care, Guy’s and St Thomas Hospital, London, UK

    Marlies Ostermann

  2. Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy

    Dinna Cruz

  3. Department of Intensive Care Medicine, Erasmus Medical Centre, Doctor Molewaterplein 50-60, Rotterdam, The Netherlands

    Hilde H. R. De Geus

Authors
  1. Marlies Ostermann
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  2. Dinna Cruz
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  3. Hilde H. R. De Geus
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Corresponding author

Correspondence to Marlies Ostermann .

Editor information

Editors and Affiliations

  1. Department of Intensive Care, VU University Hospital, Amsterdam, The Netherlands

    Heleen M. Oudemans-van Straaten

  2. Department of Intensive Care Medicine, Anaesthesia Critical Care Collaborative, Research Group (SPACeR) and Faculty of Health Care Sciences, Royal Surrey County Hospital NHS, Foundation Trust, Surrey Perioperative, University of Surrey, Guildford, United Kingdom

    Lui G. Forni

  3. Department of Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands

    A.B. Johan Groeneveld

  4. Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

    Sean M. Bagshaw

  5. Division of Intensive Care and Emergency Medicine, Department of General Internal Medicine, Medical University Innsbruck, Anichstrasse, Innsbruck, Austria

    Michael Joannidis

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© 2015 Springer International Publishing

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Ostermann, M., Cruz, D., De Geus, H.H.R. (2015). Acute Kidney Injury Biomarkers. In: Oudemans-van Straaten, H., Forni, L., Groeneveld, A., Bagshaw, S., Joannidis, M. (eds) Acute Nephrology for the Critical Care Physician. Springer, Cham. https://doi.org/10.1007/978-3-319-17389-4_9

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  • DOI: https://doi.org/10.1007/978-3-319-17389-4_9

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17388-7

  • Online ISBN: 978-3-319-17389-4

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