Biomarkers of acute kidney injury: time to learn from implementations

Endre, Zoltán H.

doi:10.51893/2021.2.pov1

Cited by 2 publications

(3 citation statements)

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“…First, few centres currently have access to rapid turn‐around biomarker assays to incorporate these into AKI diagnosis. However, this is now needed to allow clinicians to learn how to use kidney biomarkers in practice 100 . The second is that few kidney damage biomarkers have well characterized cut‐offs for diagnosis and such cut‐offs vary among different AKI contexts including clinical settings and comorbidities.…”

Section: Some Things Last Forever – the Consequences Of Akimentioning

confidence: 99%

“…However, this is now needed to allow clinicians to learn how to use kidney biomarkers in practice. 100 The second is that few kidney damage biomarkers have well characterized cut‐offs for diagnosis and such cut‐offs vary among different AKI contexts including clinical settings and comorbidities. Kidney biomarker thresholds that have been assessed in international studies are shown in Table 2 , but further studies are necessary to validate cut‐off values in specific populations.…”

Section: Some Things Last Forever – the Consequences Of Akimentioning

confidence: 99%

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Definitions, phenotypes, and subphenotypes in acute kidney injury—Moving towards precision medicine

Rodrigues

Endre

2022

Nephrology

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The current definition of acute kidney injury (AKI) is generic and, based only on markers of function, is unsuitable for guiding individualized treatment. AKI is a complex syndrome with multiple presentations and causes. Targeted AKI management will only be possible if different phenotypes and subphenotypes of AKI are recognised, based on causation and related pathophysiology. Molecular signatures to identify subphenotypes are being recognised, as specific biomarkers reveal activated pathways. Assessment of individual clinical risk needs wider dissemination to allow identification of patients at high risk of AKI. New and more timely markers for glomerular filtration rate (GFR) are available. However, AKI diagnosis and classification should not be limited to GFR, but include tubular function and damage. Combining damage and stress biomarkers with functional markers enhances risk prediction, and identifies a population enriched for clinical trials targeting AKI. We review novel developments and aim to encourage implementation of these new techniques into clinical practice as a strategy for individualizing AKI treatment akin to a precision medicine-based approach.

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Section: Some Things Last Forever – the Consequences Of Akimentioning

confidence: 99%

Section: Some Things Last Forever – the Consequences Of Akimentioning

confidence: 99%

Definitions, phenotypes, and subphenotypes in acute kidney injury—Moving towards precision medicine

Rodrigues

Endre

2022

Nephrology

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“… 4 Finally, the point of view article introduces and updates the concept of acute kidney injury (AKI) biomarkers and their meaning and utility. 5 All three are fundamental reading for Australian and New Zealand intensivists.…”

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confidence: 99%

In this Issue of CCR

Bellomo¹

2021

Critical Care and Resuscitation

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What is delirium? How do we diagnose it? What is the difference between delirium and behavioural disturbance? Is delirium a useful clinical construct? Is behavioural disturbance a more useful clinical construct for intensivists? Can we do large-scale epidemiological assessment of behavioural disturbance given that it is not a binary state and that it cannot be diagnosed by numbers? These are fundamental questions in the practice of modern intensive care medicine given that such “states” appear to affect one-third or more of patients admitted to the intensive care unit (ICU). In this issue of Critical Care and Resuscitation, we present the first attempt to address this concept using the technique of natural language processing and applying it to electronic ICU notes by nurses, doctors and allied health staff. The findings may surprise you, fascinate you, and make you think about these concepts from a different perspective, as summarised in a thoughtful editorial by Professor Reade.

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Biomarkers of acute kidney injury: time to learn from implementations

Abstract: Acute kidney injury (AKI) is a major clinical problem in the community and in hospital, with hospital-acquired AKI reported in about 20% of adult and 30% of paediatric admissions.

Cited by 2 publications

References 30 publications

Definitions, phenotypes, and subphenotypes in acute kidney injury—Moving towards precision medicine

Definitions, phenotypes, and subphenotypes in acute kidney injury—Moving towards precision medicine

In this Issue of CCR

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