Biomarkers for Acute Kidney Injury: Where Are We Today? Where Should We Go?

[摘要] Acute kidney injury (AKI)10 is an important health problem. Patients who develop AKI have markedly increased in-hospital mortality, and they have an increased likelihood of morbidity and mortality over the long term even if they do survive. Current treatments focus on supportive care and avoiding the potential for injury, such as from nephrotoxic drugs and intravenous contrast agents. Potentially more-specific therapies have been identified with animal models, but they have not demonstrated efficacy in subsequent human clinical trials, in part because AKI is difficult to identify before there is loss of organ function, at which point the damage may be irreversible. Therefore, there has been much interest in the development of biomarkers for identifying AKI in its earliest stage, when interventions might be more successful. There is also keen interest in stratifying the patients at greatest risk for AKI so that preventive treatments can be initiated in a timely fashion. In this Q&A, 5 researchers with vast clinical experience in AKI and biomarker development discuss the current status of the field (for suggested readings on this topic, see the Data Supplement that accompanies the online version of this Q&A at http://www.clinchem.org/content/vol60/issue2).What aspects of AKI do you study? Lakhmir Chawla: I am involved in the study of inflammation and AKI, AKI biomarkers, AKI risk prediction, AKI as a cause of chronic kidney disease (CKD), and AKI therapeutics.Kianoush Kashani: I am currently working on risk stratification models for prediction of AKI, novel biomarkers of early detection of AKI, derivation and validation of a renal angina model, and development and validation of electronic surveillance tools for early detection of AKI.John Kellum: I am interested in all forms of AKI, but mainly those that arise as a consequence of critical illness—so sepsis-induced AKI is at the top of the …

[学科分类] 过敏症与临床免疫学