Acute Kidney Injury: Biomarker-Guided Diagnosis and Management

Acute kidney injury (AKI) is a common clinical syndrome that is characterized by abnormal renal function and structure. The Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference in 2019 reviewed the stages of AKI and the definitions of AKI-related terminologies, and discussed th...

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Published in:Medicina (Kaunas, Lithuania) Lithuania), 2022-02, Vol.58 (3), p.340
Main Authors: Yoon, Soo-Young, Kim, Jin-Sug, Jeong, Kyung-Hwan, Kim, Su-Kang
Format: Article
Language:English
Subjects:
acute kidney injury
Acute Kidney Injury - diagnosis
Acute Kidney Injury - etiology
Acute Kidney Injury - therapy
biomarker
Biomarkers
Biopsy
Blood pressure
Creatinine
diagnosis
Early Diagnosis
Glycoproteins
Hemodynamics
Humans
Intensive care
Kidney diseases
management
Patients
prediction
prognosis
Renal Replacement Therapy
Review
Risk assessment
Sepsis
Surgery
Urine
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Summary:Acute kidney injury (AKI) is a common clinical syndrome that is characterized by abnormal renal function and structure. The Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference in 2019 reviewed the stages of AKI and the definitions of AKI-related terminologies, and discussed the advances in the last decade. Along with serum creatinine level and urine output, more accurate novel biomarkers for predicting AKI are being applied for the early detection of renal dysfunction. A literature search was conducted in PubMed, Scopus, Medline, and ClinicalTrials.gov using the terms AKI and biomarker, combined with diagnosis, management, or prognosis. Because of the large volume of data (160 articles) published between 2005 and 2022, representative literature was chosen. A number of studies have demonstrated that new biomarkers are more sensitive in detecting AKI in certain populations than serum creatinine and urine output according to the recommendations from the Acute Disease Quality Initiative Consensus Conference. To be specific, there is a persistently unresolved need for earlier detection of patients with AKI before AKI progresses to a need for renal replacement therapy. Biomarker-guided management may help to identify a high-risk group of patients in progression to severe AKI, and decide the initiation time to renal replacement therapy and optimal follow-up period. However, limitations such as biased data to certain studied populations and absence of cutoff values need to be solved for worldwide clinical use of biomarkers in the future. Here, we provide a comprehensive review of biomarker-based AKI diagnosis and management and highlight recent developments.
ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina58030340