Ibrahim Sandokji1,2, Jason H Greenberg1,2. 1. Department of Pediatrics, Section of Nephrology, Yale University School of Medicine. 2. Yale Program of Applied Translational Research, Yale University School of Medicine, New Haven, Connecticut, USA.
Abstract
PURPOSE OF REVIEW: The clinical diagnosis of acute kidney injury (AKI) relies largely on changes in serum creatinine; a delayed biomarker. Research in children has been focused on developing novel AKI biomarkers, which can improve the prediction, early detection and diagnosis of kidney injury, as well as our understanding of AKI pathophysiology. In this review, we describe recently published studies on urine or blood biomarkers of AKI. The mechanistic relevance of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, interleukin (IL)-18, liver-type fatty acid binding protein, tissue inhibitor of metalloproteinase (TIMP)-2/insulin-like growth factor-binding protein (IGFBP)-7, uromodulin, as well as other inflammatory biomarkers are discussed in the context of AKI pathophysiology, as well as their performance predicting or diagnosing AKI. RECENT FINDINGS: Biomarkers of tubular injury, cell cycle arrest and inflammation are presented in this review. NGAL continues to be the most frequently studied biomarker and continues to have good performance in a variety of clinical settings, most notably after cardiopulmonary bypass. We also found promising results with less studied biomarkers for the prediction of AKI in children, including TIMP2, IGFBP7, uromodulin, tumor necrosis factor-α and IL-8. SUMMARY: Identifying new AKI biomarkers is a priority in pediatric nephrology research because of the morbidity associated with AKI, as well as the lack of therapies for AKI. Recent research suggests that novel AKI biomarkers have the potential to predict the development of AKI and diagnose AKI earlier than changes in serum creatinine. The diverse causes of AKI, the different settings where patients develop AKI and the changing biomarker reference ranges throughout childhood remain challenges in biomarker development.
PURPOSE OF REVIEW: The clinical diagnosis of acute kidney injury (AKI) relies largely on changes in serum creatinine; a delayed biomarker. Research in children has been focused on developing novel AKI biomarkers, which can improve the prediction, early detection and diagnosis of kidney injury, as well as our understanding of AKI pathophysiology. In this review, we describe recently published studies on urine or blood biomarkers of AKI. The mechanistic relevance of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, interleukin (IL)-18, liver-type fatty acid binding protein, tissue inhibitor of metalloproteinase (TIMP)-2/insulin-like growth factor-binding protein (IGFBP)-7, uromodulin, as well as other inflammatory biomarkers are discussed in the context of AKI pathophysiology, as well as their performance predicting or diagnosing AKI. RECENT FINDINGS: Biomarkers of tubular injury, cell cycle arrest and inflammation are presented in this review. NGAL continues to be the most frequently studied biomarker and continues to have good performance in a variety of clinical settings, most notably after cardiopulmonary bypass. We also found promising results with less studied biomarkers for the prediction of AKI in children, including TIMP2, IGFBP7, uromodulin, tumor necrosis factor-α and IL-8. SUMMARY: Identifying new AKI biomarkers is a priority in pediatric nephrology research because of the morbidity associated with AKI, as well as the lack of therapies for AKI. Recent research suggests that novel AKI biomarkers have the potential to predict the development of AKI and diagnose AKI earlier than changes in serum creatinine. The diverse causes of AKI, the different settings where patients develop AKI and the changing biomarker reference ranges throughout childhood remain challenges in biomarker development.
Authors: Kelly R McMahon; Hayton Chui; Shahrad Rod Rassekh; Kirk R Schultz; Tom D Blydt-Hansen; Cherry Mammen; Maury Pinsk; Geoffrey D E Cuvelier; Bruce C Carleton; Ross T Tsuyuki; Colin J D Ross; Prasad Devarajan; Louis Huynh; Mariya Yordanova; Frédérik Crépeau-Hubert; Stella Wang; Vedran Cockovski; Ana Palijan; Michael Zappitelli Journal: Kidney360 Date: 2021-11-03
Authors: Erika Bíró; István Szegedi; Csongor Kiss; Anna V Oláh; Mark Dockrell; Robert G Price; Tamás Szabó Journal: BMC Pediatr Date: 2022-07-20 Impact factor: 2.567
Authors: Katarzyna Mackowiak-Lewandowicz; Danuta Ostalska-Nowicka; Katarzyna Zaorska; Elzbieta Kaczmarek; Jacek Zachwieja; Martin Witt; Michal Nowicki Journal: Pediatr Nephrol Date: 2022-02-24 Impact factor: 3.651