Skip to main content

Looking for the early marker of renal injury

Abstract

Acute Kidney Injury is a complex and increasingly common syndrome. Practically all available markers reflect functional impairment rather than a true direct mark of cellular injury. An ideal AKI biomarker should be accurate, reliable, easy to measure with a standard assay, noninvasive, reproducible, and sensitive and specific with defined cutoff values. Studies have identified a relatively small number of genes that are specifically altered in acute renal tubular injury. Kim-1 is one of the best-characterized urinary biomarkers to date in both experimental animals and humans with renal disease. Also NGAL is at the top of many researchers’ lists. Other biomarkers include IL-18, N-acetyl-β-d-glucosaminidase, and urinary liver-type fatty acid binding protein.

References

  1. Morrow DA, Cannon CP, Jesse RL, Newby LK, Ravkilde J, Storrow AB, et al. National Academy of Clinical Biochemistry. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: clinical characteristics and utilization of biochemical markers in acute coronary syndromes. Clin Chem 2007; 53:552–574.

    CAS  PubMed  Google Scholar 

  2. Pépin MN, Bouchard J, Legault L, Ethier J. Diagnostic performance of fractional excretion of urea and fractional excretion of sodium in the evaluations of patients with acute kidney injury with or without diuretic treatment. Am J Kidney Dis 2007; 50:566–573.

    Article  Google Scholar 

  3. Maisel AS, Bhalla V, Braunwald E. Cardiac biomarkers: a contemporary status report. Nat Clin Pract Cardiovasc Med 2006; 3:24–34.

    Article  CAS  Google Scholar 

  4. Devarajan P. Emerging biomarkers of acute kidney injury. Contrib Nephrol 2007; 156:203–212.

    Article  Google Scholar 

  5. Nguyen MT, Dent CL, Ross GF, Harris N, Manning PB, Mitsnefes MM, et al.. Urinary aprotinin as a predictor of acute kidney injury after cardiac surgery in children receiving aprotinin therapy. Pediatr Nephrol 2008; 23:1317–1326.

    Article  Google Scholar 

  6. Amin RP, Vickers AE, Sistare F, Thompson KL, Roman RJ, Lawton M, et al. Identification of putative gene based markers of renal toxicity. Environ Health Perspect 2004; 112:465–479.

    Article  CAS  Google Scholar 

  7. Kondo C, Minowa Y, Uehara T, Okuno Y, Nakatsu N, Ono A, et al. Identification of genomic biomarkers for concurrent diagnosis of drug-induced renal tubular injury using a large-scale toxicogenomics database. Toxicology 2009; 265:15–26.

    Article  CAS  Google Scholar 

  8. Thukral SK, Nordone PJ, Hu R, Sullivan L, Galambos E, Fitzpatrick VD, et al. Prediction of nephrotoxicant action and identification of candidate toxicity-related biomarkers. Toxicol Pathol 2005; 33:343–355.

    Article  CAS  Google Scholar 

  9. Mishra J, Dent C, Tarabishi R, Mitsnefes MM, Ma Q, Kelly C, et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 2005; 365:1231–1238.

    Article  CAS  Google Scholar 

  10. Devarajan P. Emerging urinary biomarkers in the diagnosis of acute kidney injury. Expert Opin Med Diagn 2008; 2:387–398.

    Article  CAS  Google Scholar 

  11. Liangos O, Perianayagam MC, Vaidya VS, Han WK, Wald R, Tighiouart H, et al. Urinary N-acetyl-beta-(d)-glucosaminidase activity and kidney injury molecule-1 level are associated with adverse outcomes in acute renal failure. J Am Soc Nephrol 2007; 18:904–912.

    Article  CAS  Google Scholar 

  12. Van Timmeren MM, Vaidya VS, van Ree RM, Oterdoom LH, de Vries AP, Gans RO, et al. High urinary excretion of kidney injury molecule-1 is an independent predictor of graft loss in renal transplant recipients. Transplantation 2007; 84:1625–1630.

    Article  Google Scholar 

  13. Vaidya VS, Waikar SS, Ferguson MA, Collings FB, Sunderland K, Gioules C, et al. Urinary biomarkers for sensitive and specific detection of acute kidney injury in humans. Clin Transl Sci 2008; 1:200–208.

    Article  CAS  Google Scholar 

  14. Zhang PL, Rothblum LI, Han WK, Blasick TM, Potdar S, Bonventre JV. Kidney injury molecule-1 expression in transplant biopsies is a sensitive measure of cell injury. Kidney Int 2008; 73:608–614.

    Article  CAS  Google Scholar 

  15. Koyner JL, Garg AX, Coca SG, Sint K, Thiessen-Philbrook H, Patel UD, et al. Biomarkers predict progression of acute kidney injury after cardiac surgery. J Am Soc Nephrol 2012; 23:905–914.

    Article  CAS  Google Scholar 

  16. Zhang J, Goering PL, Espandiari P, Shaw M, Bonventre JV, Vaidya VS, et al. Differences in immunolocalization of Kim-1, RPA-1, and RPA-2 in kidneys of gentamicin-, cisplatin-, and valproic acid-treated rats: potential role of iNOS and nitrotyrosine. Toxicol Pathol 2009; 37:629–643.

    Article  CAS  Google Scholar 

  17. Goldstein SL, Chawla LS. Renal angina. Clin J Am Soc Nephrol 2010; 5:943–949.

    Article  Google Scholar 

  18. Basu RK, Chawla LS, Wheeler DS, Goldstein SL. Renal angina: an emerging paradigm to identify children at risk for acute kidney injury. Pediatr Nephrol 2012; 27:1067–1078.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ahmed S. A. Zaky MD.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zaky, A.S.A. Looking for the early marker of renal injury. Egypt J Intern Med 27, 45–47 (2015). https://doi.org/10.4103/1110-7782.159446

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-7782.159446

Keywords