Using biomarkers for acute kidney injury: barriers and solutions

Endre, Zoltan H. (2014) Using biomarkers for acute kidney injury: barriers and solutions. Nephron Clinical Practice, 127 1-4: 180-184. doi:10.1159/000363555


Author Endre, Zoltan H.
Title Using biomarkers for acute kidney injury: barriers and solutions
Journal name Nephron Clinical Practice   Check publisher's open access policy
ISSN 1660-2110
Publication date 2014-01
Sub-type Article (original research)
DOI 10.1159/000363555
Open Access Status
Volume 127
Issue 1-4
Start page 180
End page 184
Total pages 5
Place of publication Basel, Switzerland
Publisher S. Karger
Collection year 2015
Language eng
Abstract The clinical implementation of urinary and plasma renal injury biomarkers has been hampered by the variability associated with nonstandardized commercially available biomarker assays, uncertainty and variations in patient selection criteria, and the absence of context-specific cutoffs for biomarker concentrations. These limitations are increased by comparison with serum creatinine to define acute kidney injury. The critical problem affecting biomarker performance is patient heterogeneity involving the cause, context (including comorbidity and baseline renal function), and timing of the injury. We suggest strategies for stratifying subjects to provide appropriate context, and illustrate a creatinine-independent method for defining thresholds for biomarker concentrations in these contexts which utilizes the same sensitivity for the clinical outcomes of dialysis or death. Large multicenter cohort studies are needed to validate the proposed cutoffs.
Keyword Biomarker
Acute kidney injury
Cutoff
Critically-Ill Patients
Urinary Biomarkers
Cardiac-Surgery
Poor Outcomes
Aki
Stratification
Performance
Creatinine
Arrest
Damage
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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