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01-03-2010 | Editorial

Biomarkers and acute kidney injury: dining with the Fisher King?

Authors: Catherine S. C. Bouman, Lui G. Forni, Michael Joannidis

Published in: Intensive Care Medicine | Issue 3/2010

Excerpt

Despite its limited utility, the serum creatinine remains an essential part of both the RIFLE and AKIN criteria for the diagnosis of acute kidney injury (AKI) [1]. Due to the delayed rise in creatinine following injury, nephrologists and intensivists alike continue to search for the holy grail of AKI: an early and reliable biomarker of kidney injury. Biomarkers are biological parameters that may indicate normal or pathological processes or responses to interventions and may be objectively quantified. The sensitivity, specificity and time course of a biomarker are critical factors in determining its use in any disease process. But more importantly, the utility of a biomarker depends on the purpose it is expected to fulfill. Summarzing current literature, it appears that an ideal biomarker for AKI should fulfill the following criteria:

It should distinguish pre-renal AKI from apoptotic and necrotic injury
It should be specific for renal injury in the presence of concomitant injury involving other organs
It should allow timing of the onset or stage of injury
It should predict outcome
In the end it should act as surrogate end point useful for clincial interventional studies

…

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Title: Biomarkers and acute kidney injury: dining with the Fisher King?
Authors: Catherine S. C. Bouman
Lui G. Forni
Michael Joannidis
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1733-8

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