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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2017

01-06-2017 | Editorial

Have biomarkers failed in acute kidney injury? We are not sure

Authors: John R. Prowle, Mitchell H. Rosner

Published in: Intensive Care Medicine | Issue 6/2017

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Excerpt

Over the past decade, there has been an explosion of interest in the study of urinary and plasma biomarkers for the rapid diagnosis, molecular phenotyping and prognostication of acute kidney injury (AKI) with over 3300 publications devoted to this topic listed in PubMed during the past 10 years. More than 15 separate biomarkers, plasma and urine, have been identified and investigated to various levels, the majority in the context of AKI complicating critical illness [1]. However, opinion remains divided as to the clinical value of biomarker measurements in the care of patients at risk or with AKI, as reflected in opposing opinion pieces in this issue of Intensive Care Medicine. While we agree that AKI biomarkers are not ready for implementation in routine care, we feel that progress is being made and that, ultimately, there may be important roles for these tools in the care of critically ill patients. …
Literature
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Malhotra R, Siew ED (2017) Biomarkers for the early detection and prognosis of acute kidney injury. Clin J Am Soc Nephrol 12:149–173CrossRefPubMed
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Mishra J, Dent C, Tarabishi R, Mitsnefes MM, Ma Q, Kelly C, Ruff SM, Zahedi K, Shao M, Bean J, Mori K, Barasch J, Devarajan P (2005) Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 365:1231–1238CrossRefPubMed
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Paragas N, Qiu A, Zhang Q, Samstein B, Deng SX, Schmidt-Ott KM, Viltard M, Yu W, Forster CS, Gong G, Liu Y, Kulkarni R, Mori K, Kalandadze A, Ratner AJ, Devarajan P, Landry DW, D’Agati V, Lin CS, Barasch J (2011) The Ngal reporter mouse detects the response of the kidney to injury in real time. Nat Med 17:216–222CrossRefPubMedPubMedCentral
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Xu K, Rosenstiel P, Paragas N, Hinze C, Gao X, Huai Shen T, Werth M, Forster C, Deng R, Bruck E, Boles RW, Tornato A, Gopal T, Jones M, Konig J, Stauber J, D’Agati V, Erdjument-Bromage H, Saggi S, Wagener G, Schmidt-Ott KM, Tatonetti N, Tempst P, Oliver JA, Guarnieri P, Barasch J (2016) Unique transcriptional programs identify subtypes of AKI. J Am Soc Nephrol. doi:10.​1681/​ASN.​2016090974
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Alge JL, Arthur JM (2015) Biomarkers of AKI: a review of mechanistic relevance and potential therapeutic implications. Clin J Am Soc Nephrol 10:147–155CrossRefPubMed
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Wu H, Craft ML, Wang P, Wyburn KR, Chen G, Ma J, Hambly B, Chadban SJ (2008) IL-18 contributes to renal damage after ischemia-reperfusion. J Am Soc Nephrol 19:2331–2341CrossRefPubMedPubMedCentral
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Meersch M, Schmidt C, Hoffmeier A, Van Aken H, Wempe C, Gerss J, Zarbock A (2017) Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. Intensive Care Med. doi:10.​1007/​s00134-016-4670-3
Metadata
Title
Have biomarkers failed in acute kidney injury? We are not sure
Authors
John R. Prowle
Mitchell H. Rosner
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 6/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-017-4763-7

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