Evolving use of biomarkers for kidney injury in acute care settings.
OBJECTIVE
Acute kidney injury is increasingly recognized in acute care settings in more recent years. Proper diagnosis and risk stratification for acute kidney injury is necessary for carrying out appropriate and cost-effective treatments in patients with acute kidney injury. Kidney markers serve as diagnostic and prognostic tools to give physicians a more complete perspective of renal insult. The aim of this review is to highlight some of the evidence from recent studies, involving kidney markers and provide current opinion on the accuracy of these markers.


RESULTS
Recent studies demonstrate that novel kidney markers such as cystatin C, interleukin-18, kidney injury molecule 1, and neutrophil gelatinase-associated lipocalin serve as more accurate markers for acute kidney injury as compared with the more traditional marker, creatinine. Additionally, there seems to be a correlation between the concentrations of each marker and the level of deterioration of kidneys, patient recovery time, length of hospital stay, and hospital costs.


CONCLUSIONS
Each individual kidney marker possesses its own strengths and weaknesses in determining the onset and severity of acute kidney injury. However, in combination, a panel of kidney markers may serve as powerful tools in diagnosing kidney injury with high accuracy.
Ho
Elliot
E
Division of Cardiology, Department of Medicine, San Diego Veterans Affairs Medical Center and University of California San Diego, CA 92161, USA.
Fard
Arrash
A
Maisel
Alan
A
D058186:Acute Kidney Injury / Q000097:blood* / Q000378:metabolism* / Q000503:physiopathology; D000209:Acute-Phase Proteins; D015415:Biomarkers / Q000032:analysis; D055316:Cystatin C / Q000097:blood; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007362:Intensive Care Units; D020382:Interleukin-18 / Q000097:blood; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D008562:Membrane Glycoproteins / Q000097:blood; D011518:Proto-Oncogene Proteins / Q000097:blood; D011991:Receptors, Virus / Q000097:blood
D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus