Korean J Lab Med.  2011 Apr;31(2):72-80. 10.3343/kjlm.2011.31.2.72.

New Biomarkers of Acute Kidney Injury and the Cardio-renal Syndrome

Affiliations
  • 1Department of Laboratory Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore. Robert_Hawkins@ttsh.com.sg

Abstract

Changes in renal function are one of the most common manifestations of severe illness. There is a clinical need to intervene early with proven treatments in patients with potentially deleterious changes in renal function. Unfortunately progress has been hindered by poor definitions of renal dysfunction and a lack of early biomarkers of renal injury. In recent years, the definitional problem has been addressed with the establishment of a new well-defined diagnostic entity, acute kidney injury (AKI), which encompasses the wide spectrum of kidney dysfunction, together with clearer definition and sub-classification of the cardio-renal syndromes. From the laboratory have emerged new biomarkers which allow early detection of AKI, including neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C. This review describes the new concepts of AKI and the cardio-renal syndromes as well as novel biomarkers which allow early detection of AKI. Panels of AKI biomarker tests are likely to revolutionise the diagnosis and management of critically ill patients in the coming years. Earlier diagnosis and intervention should significantly reduce the morbidity and mortality associated with acute kidney damage.

Keyword

Acute kidney injury; Cardio-renal syndrome; Acute renal failure; Neutrophil gelatinase-associated lipocalin; Cystatin C; Creatinine; Renal function; Heart failure

MeSH Terms

Acute Kidney Injury/*diagnosis
Biological Markers/analysis/blood/urine
Cystatin C/blood/urine
Heart Failure/complications/etiology
Humans
Kidney Diseases/complications/*diagnosis/etiology
Lipocalins/blood/urine
Syndrome
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