잠시만 기다려 주세요. 로딩중입니다.

Biomarker-Guided Risk Assessment for Acute Kidney Injury: Time for Clinical Implementation?

Annals of Laboratory Medicine 2021년 41권 1호 p.1 ~ 15
Albert Christian, Haase Michael, Albert Annemarie, Zapf Antonia, Braun-Dullaeus Rudiger Christian, Haase-Fielitz Anja,
소속 상세정보
 ( Albert Christian ) - Otto-von-Guericke-University Magdeburg University Clinic for Cardiology and Angiology Medical Faculty
 ( Haase Michael ) - MVZ Potsdam Diaverum Renal Services
 ( Albert Annemarie ) - Klinikum Ernst von Bergmann Department of Nephrology and Endocrinology
 ( Zapf Antonia ) - University Medical Center Hamburg-Eppendorf Department of Medical Biometry and Epidemiology
 ( Braun-Dullaeus Rudiger Christian ) - Otto-von-Guericke-University Magdeburg University Clinic for Cardiology and Angiology Medical Faculty
 ( Haase-Fielitz Anja ) - Brandenburg Medical School Theodor Fontane Department of Cardiology

Abstract


Acute kidney injury (AKI) is a common and serious complication in hospitalized patients, which continues to pose a clinical challenge for treating physicians. The most recent Kidney Disease Improving Global Outcomes practice guidelines for AKI have restated the importance of earliest possible detection of AKI and adjusting treatment accordingly. Since the emergence of initial studies examining the use of neutrophil gelatinase-associated lipocalin (NGAL) and cycle arrest biomarkers, tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein (IGFBP7), for early diagnosis of AKI, a vast number of studies have investigated the accuracy and additional clinical benefits of these biomarkers. As proposed by the Acute Dialysis Quality Initiative, new AKI diagnostic criteria should equally utilize glomerular function and tubular injury markers for AKI diagnosis. In addition to refining our capabilities in kidney risk prediction with kidney injury biomarkers, structural disorder phenotypes referred to as “preclinical-” and “subclinical AKI” have been described and are increasingly recognized. Additionally, positive biomarker test findings were found to provide prognostic information regardless of an acute decline in renal function (positive serum creatinine criteria). We summarize and discuss the recent findings focusing on two of the most promising and clinically available kidney injury biomarkers, NGAL and cell cycle arrest markers, in the context of AKI phenotypes. Finally, we draw conclusions regarding the clinical implications for kidney risk prediction.

키워드

Acute kidney injury; AKI phenotypes; Neutrophil gelatinase-associated lipocalin; Subclinical AKI; Preclinical AKI; Kidney biomarker; Serum creatinine; Kidney risk prediction; Cell cycle arrest biomarker

원문 및 링크아웃 정보

등재저널 정보