title: Novel biomarkers of acute kidney injury: Evaluation and evidence in urologic surgery.
abstract: Patients undergoing urologic surgery are at risk of acute kidney injury (AKI) and consequently long-term deterioration in renal function. AKI is further associated with significantly higher odds of perioperative complications, prolonged hospital stay, higher mortality and costs. Therefore, better awareness and detection of AKI, as well as identification of AKI determinants in the urological surgery setting is warranted to pre-empt and mitigate further deterioration of renal function in patients at special risk. New consensus criteria provide precise definitions of diagnosis and description of the severity of AKI. However, they rely on serum creatinine (SCr), which is known to be an inaccurate marker of early changes in renal function. Therefore, several new urinary and serum biomarkers promise to address the gap associated with the use of SCr. Novel biomarkers may complement SCr measurement or most likely improve the diagnostic accuracy of AKI when used in combinations. However, novel biomarkers have to prove their clinical applicability, accuracy, and cost effectiveness prior to implementation into clinical practice. Most preferably, novel biomarkers should help to positively improve a patient's long-term renal functional outcomes. The purpose of this review is to discuss currently available biomarkers and to review their clinical evidence within urologic surgery settings.
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Marianne
authors.initials: M
authors.lastname: Schmid
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Deepansh
authors.initials: D
authors.lastname: Dalela
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Rana
authors.initials: R
authors.lastname: Tahbaz
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Jessica
authors.initials: J
authors.lastname: Langetepe
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Marco
authors.initials: M
authors.lastname: Randazzo
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Roland
authors.initials: R
authors.lastname: Dahlem
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: Marianne Schmid, Deepansh Dalela, Quoc-Dien Trinh, Center for Surgery and Public Health and Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Felix K-H
authors.initials: FK
authors.lastname: Chun
keywords: Acute kidney injury; Biomarker; Outcome; Renal function; Surgery; Urology