Precision and improving outcomes in acute kidney injury: Personalizing the approach.
It is now well over a decade since attempts at harmonization of acute renal failure into a definable entity termed acute kidney injury. This has led to several landmark studies outlining the epidemiology of acute kidney injury, particularly in the critically ill, as well as providing insights into the long-term effects of the syndrome. Despite the introduction of consensus definitions and improvement in recognition, this has not been translated into outcome benefits as yet. The introduction of novel biomarkers associated with renal damage was primarily aimed at aiding early recognition of acute kidney injury. We argue that, in the future, using biomarkers may not only alert to acute kidney injury but may direct therapy in a personalized fashion rather than a one-size-fits-all approach.
Surrey Perioperative Anaesthesia & Critical Care Collaborative Research Group (SPACeR), Department of Clinical & Experimental Medicine, University of Surrey, Guildford UK & Intensive Care Unit, Royal Surrey County Hospital NHS Foundation Trust, Egerton Rd, Guildford, UK, GU2 7XX. Electronic address: luiforni@nhs.net.
Lui G
LG
Forni
Division Intensive Care Medicine, Department of Veterans Affairs Medical Center, Washington, DC, USA.
Lakhmir
L
Chawla
International Renal Research Institute Vicenza & Department of Nephrology, St Bortolo Hospital, Vicenza, Italy.
Claudio
C
Ronco
D058186:Acute Kidney Injury / Q000378:metabolism / Q000628:therapy*; D015415:Biomarkers; D016638:Critical Illness; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000378:metabolism; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000378:metabolism; D007668:Kidney; D057285:Precision Medicine; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000378:metabolism
D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D018969:Insulin-Like Growth Factor Binding Proteins; C560823:TIMP2 protein, human; C102529:insulin-like growth factor binding protein-related protein 1; D019716:Tissue Inhibitor of Metalloproteinase-2
Acute kidney injury; Biomarkers; Chronic kidney disease; Personalized medicine