Technology Insight: biomarker development in acute kidney injury--what can we anticipate?

Early diagnosis has been the 'Achilles heel' of acute kidney injury (AKI) that has prevented successful implementation of treatment strategies. To date, pharmacological intervention has been largely unsuccessful or equivocal, and morbidity and mortality associated with AKI have remained unacceptably high. Despite their well-known limitations, the most widely used biomarkers for the early diagnosis of AKI are serum creatinine, blood urea nitrogen and urine output. Development of new biomarkers is imperative. A variety of methods have been employed to discover new biomarkers of AKI, including transcriptomics, proteomics, gene arrays, lipidomics and imaging technologies. Clinical trials are underway to establish the validity of the biomarkers discovered using these techniques. This Review summarizes the importance of biomarkers of AKI, from their discovery to clinical practice, from the current perspective and that of what to expect in the future. Great strides forward are being made in breaking down important barriers to the successful prevention and treatment of this devastating disorder.