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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2015

01-04-2015 | Editorial

Biomarkers for AKI improve clinical practice: no

Authors: Marlies Ostermann, Michael Joannidis

Published in: Intensive Care Medicine | Issue 4/2015

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Excerpt

Despite recent developments in definition and staging, the diagnosis of (AKI) acute kidney injury is still based on oliguria and/or an increase in serum creatinine [1]. Consequently, research in the last decade has focussed on the discovery and validation of more specific and sensitive markers of tubular damage/functional impairment. The most advanced biomarkers promise to identify patients at risk of AKI, diagnose AKI earlier than conventional tests and prognosticate risk of progression, including need for (RRT) renal replacement therapy [2‐16]. The hope is that, with such an approach and more timely and relevant interventions, the outcome of patients with AKI can be improved. Commercial biomarker kits are now available in most countries. However, like any other new diagnostic test, these novel AKI biomarkers need to add value above and beyond currently available tools, before being incorporated into routine clinical practice. It is therefore essential to have a close look at the expectations of AKI biomarkers and their actual performance and potential role in practice. …
Literature
1.
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012) KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2:1–138CrossRef
2.
Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A, NGAL Meta-analysis Investigator Group (2009) Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis 54:1012–1024CrossRefPubMed
3.
Wagener G, Gubitosa G, Wang S, Borregaard N, Kim M, Lee HT (2008) Urinary neutrophil gelatinase-associated lipocalin and acute kidney injury after cardiac surgery. Am J Kidney Dis 52(3):425–433CrossRefPubMed
4.
Martensson J, Bell M, Oldner A, Xu S, Venge P, Martling CR (2010) Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury. Intensive Care Med 36:1333–1340CrossRefPubMed
5.
Haase M, Bellomo R, Devarajan P, Ma Q, Bennett MR, Möckel M, Matalanis G, Dragun D, Haase-Fielitz A (2009) Novel biomarkers early predict the severity of acute kidney injury after cardiac surgery in adults. Ann Thorac Surg 88:124–130CrossRefPubMed
6.
Ristikankare A, Poyhia R, Kuitunen A, Skrifvars M, Hämmäinen P, Salmenperä M, Suojaranta-Ylinen R (2010) Serum cystatin C in elderly cardiac surgery patients. Ann Thorac Surg 89:689–694CrossRefPubMed
7.
Soto K, Coelho S, Rodriques B, Martins H, Frade F, Lopes S, Cunha L, Papoila AL, Devarajan P (2010) Cystatin C as a marker of acute kidney injury in the emergency department. Clin J Am Soc Nephrol 5(10):1745–1754CrossRefPubMedCentralPubMed
8.
Perianayagam MC, Seabra VF, Tighiouart H, Liangos O, Jaber BL (2009) Serum cystatin C for prediction of dialysis requirement or death in acute kidney injury: a comparative study. Am J Kidney Dis 54:1025–1033CrossRefPubMed
9.
Nejat M, Pickering JW, Walker RJ, Westhuyzen J, Shaw GM, Frampton CM, Endre ZH (2010) Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit. Crit Care 14(3):R85CrossRefPubMedCentralPubMed
10.
Tu Y, Wang H, Suni R, Ni Y, Ma L, Xv F, Hu X, Jiang L, Wu A (2014) Urinary netrin-1 and KIM-1 as early biomarkers for septic acute kidney injury. Ren Fail 26:1–5
11.
Parikh CR, Thiessen-Philbrook H, Garg AX, Kadiyala D, Shlipak MG, Koyner JL, Edelstein CL, Devarajan P, Patel UD, Zappitelli M, Krawczeski CD, Passik CS, Coca SG, TRIBE-AKI Consortium (2013) Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery. Clin J Am Soc Nephrol 8(7):1079–1088CrossRefPubMedCentralPubMed
12.
Parr SK, Clark AJ, Bian A, Shintani AK, Wickersham NE, Ware LB, Ikizler TA, Siew ED (2014) Urinary L-FABP predicts poor outcomes in critically ill patients with early acute kidney injury. Kidney Int. doi:10.​1038/​ki.​2014.​301 PubMed
13.
Arthur JM, Hill EG, Alge JL, Lewis EC, Neely BA, Janech MG, Tumlin JA, Chawla LS, Shaw AD, SAKInet Investigators (2014) Evaluation of 32 urine biomarkers to predict the progression of acute kidney injury after cardiac surgery. Kidney Int 85(2):431–438CrossRefPubMedCentralPubMed
14.
Kashani K, Al-Khafaji A, Ardiles T et al (2013) Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit Care 17:R25CrossRefPubMedCentralPubMed
15.
Hoste EA, McCullough PA, Kashani K, Chawla LS, Joannidis M, Shaw AD, Feldkamp T, Uettwiller-Geiger DL, McCarthy P, Shi J, Walker MG, Kellum JA; for the Sapphire Investigators (2014) Derivation and validation of cutoffs for clinical use of cell cycle arrest biomarkers. Nephrol Dial Transplant. pii:gfu292 (Epub ahead of print. PubMed PMID: 25237065)
16.
Bihorac A, Chawla LS, Shaw AD et al (2014) Validation of cell-cycle arrest biomarkers for acute kidney injury using clinical adjudication. Am J Respir Crit Care Med 189:932–939CrossRefPubMed
17.
Glassford NJ, Schneider AG, Xu S et al (2013) The nature and discriminatory value of urinary neutrophil gelatinase-associated lipocalin in critically ill patients at risk of acute kidney injury. Intensive Care Med 39:1714–1724CrossRefPubMed
18.
Legrand M, Darmon M, Joannidis M (2013) NGAL and AKI: the end of a myth? Intensive Care Med 39(10):1861–1863CrossRefPubMed
19.
20.
Endre Z, Walker R, Pickering J et al (2010) Early intervention with erythropoietin does not affect the outcome of acute kidney injury (the EARLYARF trial). Kidney Int 77:1020–1030CrossRefPubMed
Metadata
Title
Biomarkers for AKI improve clinical practice: no
Authors
Marlies Ostermann
Michael Joannidis
Publication date
01-04-2015
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 4/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3540-0

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