Advances in the study of subclinical AKI biomarkers

Abstract

Acute kidney injury (AKI) is a prevalent and serious illness in all clinical departments, with a high morbidity and death rate, particularly in intensive care units, where prevention and treatment are crucial. As a result, active prevention, early detection, and timely intervention for acute kidney injury are critical. The current diagnostic criteria for acute kidney injury are an increase in serum creatinine concentration and/or a decrease in urine output, although creatinine and urine output merely reflect changes in kidney function, and AKI suggests injury or damage, but not necessarily dysfunction. The human kidney plays a crucial functional reserve role, and dysfunction is only visible when more than half of the renal mass is impaired. Tubular damage markers can be used to detect AKI before filtration function is lost, and new biomarkers have shown a new subset of AKI patients known as “subclinical AKI.” Furthermore, creatinine and urine volume are only marginally effective for detecting subclinical AKI. As a result, the search for new biomarkers not only identifies deterioration of renal function but also allows for the early detection of structural kidney damage. Several biomarkers have been identified and validated. This study discusses some of the most promising novel biomarkers of AKI, including CysC, NGAL, KIM-1, lL-18, L-FABP, IGFBP7, TIMP-2, Clusterin, and Penkid. We examine their performance in the diagnosis of subclinical AKI, limitations, and future clinical practice directions.

Future Directions in Optimizing Anesthesia to Reduce Perioperative Acute Kidney Injury

“…In a pediatric liver transplantation trial, patients in the sevoflurane group had more stable hemodynamics and significantly lower levels of TNF-α, IL-18, and serum NGAL during hepatic reperfusion than those in the propofol group. NGAL is a marker of renal injury which is significantly elevated in urine after AKI [65, 66]. Compared to propofol, sevoflurane anesthesia may be associated with a small decrease in the incidence of AKI after pediatric liver transplantation [7].…”

Биологические Маркеры Сепсиса

“…Проэнкефалин A 119-159 (Penkid) представляет собой пептид с молекулярной массой 5 кДа, который идентичен предшественникам метэнкефалинов и лей-энкефалинов и считается альтернативным маркером эндогенных опиоидных пептидных энкефалинов. Энкефалины участвуют в различных физиологических процессах путем связывания с опиоидными рецепторами [94].…”

Pre-clinical Evaluation of Biomarkers for Early Detection of Nephrotoxicity Following Alpha-particle Radioligand Therapy

“…Additionally, long-term toxicity evaluation is limited by the patient population's poor survival. In comparison, urinary biomarkers such as Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule 1 (KIM-1), and Epidermal Growth Factor (EGF) have been used to detect AKI early in patients with normal sCr (subclinical AKI) and to evaluate overall tubular health [15]. The change in their urinary secretion pattern has been used to identify patients at risk of progressive CKD [16].…”