Biomarkers for Diagnosis of Acute Kidney Injury
Much of the current clinical investigation regarding AKI has focused on the use of novel biomarkers for the prompt diagnosis of AKI. Biomarkers under investigation include neutrophil gelatinase associated lipocalin (NGAL), interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), cystatin C (CysC), tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7), and liver fatty acid-binding protein (L-FABP).64 The promise in these biomarkers is that they may identify AKI earlier in the course of renal injury than SCr elevation, allowing more timely diagnosis and intervention. Urinary biomarkers have shown limited ability to detect pAKI at the pRIFLE Risk stage, but greater promise in identifying patients at the pRIFLE Injury stage in the emergency setting.91
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