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Logo of aicSpringerOpen.comThis journalSubmit a manuscriptRegisterSpringerOpen.comAnnals of Intensive Care
 
Ann Intensive Care. 2012; 2: 24.
Published online Jul 2, 2012. doi:  10.1186/2110-5820-2-24
PMCID: PMC3475083
Biomarkers for early diagnosis of AKI in the ICU: ready for prime time use at the bedside?
Patrick M Honore,corresponding author1,5 Rita Jacobs,1 Olivier Joannes-Boyau,2 Lies Verfaillie,1 Jouke De Regt,1 Viola Van Gorp,1 Elisabeth De Waele,1 Willem Boer,3 Vincent Collin,4 and Herbert D Spapen1
1Intensive Care Dept, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
2Haut Leveque University Hospital of Bordeaux, University of Bordeaux 2, Pessac, France
3Department of Anaesthesiology and Critical Care Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
4Cliniques de l’Europe-Site St Michel, Brussels, Belgium
5Critical Care Nephrology Platform, Intensive Care Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
corresponding authorCorresponding author.
Patrick M Honore: Patrick.Honore/at/uzbrussel.be; Rita Jacobs: Rita.Jacobs/at/uzbrussel.be; Olivier Joannes-Boyau: olivier.joannes-boyau/at/chu-bordeaux.fr; Lies Verfaillie: lies_verfaillie/at/uzbrussel.be; Jouke De Regt: Jouke.deregt/at/uzbrussel.be; Viola Van Gorp: viola_vangorp/at/uzbrussel.be; Elisabeth De Waele: Elisabeth.DeWaele/at/uzbrussel.be; Willem Boer: wllm.br/at/gmail.com; Vincent Collin: V.Collin/at/cliniquesdeleurope.be; Herbert D Spapen: Herbert.Spapen/at/uzbrussel.be
Received March 13, 2012; Accepted April 17, 2012.
Abstract
Because of its still rising incidence and high mortality rate in intensive care unit (ICU) patients, early recognition of acute kidney injury (AKI) remains a critical issue. Surprisingly, effective biomarkers for early detection and hence appropriate and timely therapy of AKI have not yet entered the clinical arena. We performed a systematic search of the literature published between 1999 and 2011 on potential early biomarkers for acute renal failure/kidney injury in an at-risk adult and pediatric population following the Quorum Guidelines. Based on this review, recommendations for the clinical use of these biomarkers were proposed. In general, kidney biomarkers may aid to direct early aggressive treatment strategies for AKI thereby decreasing the associated high mortality. To date, however, sensitivity and specificity of individual biomarker assays are low and do not sustain their routine clinical use. “Kits” containing a combination of established biomarkers, in conjunction with measured glomerular filtration rate, may enhance diagnostic and prognostic accuracy in the future.
Keywords: Hemofiltration, Biomarkers, Early diagnosis, Sepsis, Septic shock, SIRS, Acute kidney injury, Acute tubular apoptosis, Sepsis modulation, Blood purification, Dialysis, CRRT, Review
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