Biomarkers of renal recovery after acute kidney injury

Abstract

Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery. The reference lists of these articles and relevant review articles were also reviewed. Final references were selected for inclusion in the review based on their relevance. New biomarkers exhibited a potential role in the early diagnosis of acute kidney injury recovery. Urine HGF, IGFBP-7, TIMP-2 and NGAL may improve our ability to predict the odds and timing of recovery and eventually renal support withdrawal. Acute kidney injury recovery requires more study, and its definition needs to be standardized to allow for better and more powerful research on biomarkers because some of them show potential for the prediction of acute kidney injury recovery.

The Predictive Role of the Biomarker Kidney Molecule-1 (KIM-1) in Acute Kidney Injury (AKI) Cisplatin-Induced Nephrotoxicity

“…Its presence was associated with AKI in several experimental studies [34,41,42,43,44,45,46,47,48,49,50] and some authors suggest that it may be predictive of cisplatin nephrotoxicity [119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135]. Anti-KIM-1 antibodies have been developed as a potential therapy in neoplasia characterized by KIM-1 overexpression (renal, ovarian, and lung carcinomas) [167,168].…”

The Postoperative Plasmatic Level of Neutrophil Gelatinase-associated Lipocalin Does not Reflect its Tissue Expression in Critically ill Patients with High Abdominal Pressure

“…1), we can suppose that it might mark the immature neutrophils that are released in the systemic ciriculation in patients with septic shock [11]. It was proved that, in patients with septic shock, independently from other associated factors, a plasmatic NGAL level higher than 257 ng/ml is an independent predictor (with 68% sensitivity and 75% specificity) of non-recovered acute renal failure [15,18]. In our previously published data, the plasmatic value was restricted to 450 ng/mL [2].…”

“…In the same cases the serum urea was also increased without significant disorders of the glomerular filtration rate, without extremely high serum level of creatinine (table 2). As NGAL can be increased in patients with both subclinical or clinical acute kidney disease [6,15], it seems that the nephron is not the only source of NGAL and it does not reflect exclusively an renal impairment. It is necessary taking into account the fact that the level of plasma NGAL is also influenced by ischemia (increased serum NGAL is correlated to the cytokine levels), neoplasia, hypertension and systemic inflammatory diseases [6,14].…”

“…In our previously published data, the plasmatic value was restricted to 450 ng/mL [2]. For the urinary level, it was suggested that a value of NGAL higher than 348.2 mg/dl (sensitivity 0.84 and specificity 0.69) is a potential indicator of higher risk of mortality [15,19].…”

Changes in Water Soluble Uremic Toxins and Urinary Acute Kidney Injury Biomarkers After 10- and 100-km Runs

“…The kidney injury leads to decrease in GFR and tubular dysfunction, leading in consequence to accumulation of uremic toxins. The classical markers of AKI are creatinine, urea and uric acid [44]. All these water soluble small compounds are freely filtrated in glomeruli but their later fate in tubules differ a lot.…”