title: Biomarkers of kidney injury.
abstract: BACKGROUND
  Acute kidney injury (AKI) represents a common serious clinical problem. Up to date mortality due to AKI, especially in intensive care units, has not been changed significantly over the past 50 years. This is partly due to a delay in initiating renal protective and appropriate therapeutic measures since until now there are no reliable early-detecting biomarkers. The gold standard, serum creatinine, displays poor specificity and sensitivity with regard to recognition of the early period of AKI.
  
  
  OBJECTIVE
  Our objective was to review established markers versus novel urine and serum biomarkers of AKI in humans, which have progressed to clinical phase with regard to their diagnostic and prognostic value.
  
  
  METHODS
  A review was performed on the basis of literature search of renal failure, acute kidney injury, and biomarkers in Pubmed.
  
  
  RESULTS
  Next to established biomarkers as creatinine and cystatin C, other molecules such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), monocyte chemotactic peptide (MCP-1), Netrin-1, and interleukin (IL)-18 are available and represent promising new markers that, however, need to be further evaluated in the clinical setting for suitability.
  
  
  CONCLUSIONS
  In clinical settings with incipient AKI, not only the development and the implementation of more sensitive biomarkers are required for earlier treatment initiation in order to attenuate the severity of kidney injury, but also equally important remains the substantial improvement and application of refined and prophylactic therapeutic options in these situations.
  
  
  CONCLUSIONS
  Adequately powered clinical trials testing a row of biomarkers are warranted before they may qualify for full adoption in clinical practice.
authors.affiliation: Klinik für Urologie und Kinderurologie, Johann Wolfgang Goethe-Universitätsklinik Frankfurt, Theodor-Stern-Kai, Frankfurt am Main, Germany. Anja.Urbschat@kgu.de
authors.forename: Anja
authors.initials: A
authors.lastname: Urbschat
authors.forename: Nicholas
authors.initials: N
authors.lastname: Obermüller
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D000209:Acute-Phase Proteins / Q000652:urine; D000818:Animals; D015415:Biomarkers / Q000097:blood*; D001806:Blood Urea Nitrogen; D018932:Chemokine CCL2 / Q000652:urine; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000652:urine; D005919:Glomerular Filtration Rate; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D020382:Interleukin-18 / Q000652:urine; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008562:Membrane Glycoproteins / Q000652:urine; D009414:Nerve Growth Factors / Q000652:urine; D000075388:Netrin-1; D011507:Proteinuria / Q000652:urine; D011518:Proto-Oncogene Proteins / Q000652:urine; D011991:Receptors, Virus; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000150:complications; D025521:Tumor Suppressor Proteins / Q000652:urine
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C111835:CCL2 protein, human; C525030:CST3 protein, human; D018932:Chemokine CCL2; 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; C000617351:NTN1 protein, human; D009414:Nerve Growth Factors; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D025521:Tumor Suppressor Proteins; D000075388:Netrin-1; D003404:Creatinine; D000118:Acetylglucosaminidase