title: Mechanistic biomarkers for cytotoxic acute kidney injury.
abstract: Acute kidney injury is a common condition and is associated with a high mortality rate. It has been recognised that routinely used measures of renal function, such as levels of blood urea nitrogen and serum creatinine, increase significantly only after substantial kidney injury occurs and then with a time delay. Insensitivity of such tests delays the diagnosis in humans, making it particularly challenging to administer putative therapeutic agents in a timely fashion. Furthermore, this insensitivity affects the evaluation of toxicity in preclinical studies by allowing drug candidates, which have low, but nevertheless important, nephrotoxic side effects in animals, to pass the preclinical safety criteria only to be found to be clinically nephrotoxic with great human costs. This review presents the current status of sensitive and specific biomarkers to detect preclinical and clinical renal injury and summarises the techniques used to quantitate these biomarkers in biological fluids.
authors.affiliation: Harvard Institutes of Medicine, Brigham and Women's Hospital, Harvard Medical School, Renal Division, Rm 550, 4 Blackfan Circle, Boston, MA 02115, USA. vvaidya@partners.org
authors.forename: Vishal S
authors.initials: VS
authors.lastname: Vaidya
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Bonventre
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis* / Q000652:urine; D000818:Animals; D015415:Biomarkers / Q000652:urine; D004353:Drug Evaluation, Preclinical; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans
chemical_list: D015415:Biomarkers