Current Status of Novel Biomarkers for the Diagnosis of Acute Kidney Injury: A Historical Perspective
Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the pr...
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| Veröffentlicht in: | Journal of intensive care medicine Jg. 35; H. 5; S. 415 |
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01.05.2020
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| Abstract | Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the prevention and treatment of the disease. A lack of efficacy in drug trials led to the concern that AKI was not being diagnosed early enough for an effective intervention and that a rise in serum creatinine itself is not a sensitive-enough marker. Researchers have been searching for novel biomarkers that can not only assess a decline in kidney function but also demonstrate structural damage to the kidney and at time points earlier than increases in serum creatinine measurements allow. Over the past 10 years, there have been 3300 new publications and hundreds of new biomarkers investigated, yet concern still remains regarding AKI biomarker performance. The AKI biomarkers are yet to be widely utilized in clinical practice, leading some to question whether AKI biomarkers will ever reach their initial promise. However, we believe that biomarkers are an important part of current and future AKI research and clinical management. In this review, we compare the historical contexts of acute myocardial ischemia and AKI biomarker development to illustrate the progress that has been made within AKI biomarker research in a relatively short period of time and also to point out key differences between the disease processes that have been barriers to widespread AKI biomarker adoption. Finally, we discuss potential paths by which biomarkers can lead to appropriate AKI treatment responses that lower morbidity and mortality. |
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| AbstractList | Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the prevention and treatment of the disease. A lack of efficacy in drug trials led to the concern that AKI was not being diagnosed early enough for an effective intervention and that a rise in serum creatinine itself is not a sensitive-enough marker. Researchers have been searching for novel biomarkers that can not only assess a decline in kidney function but also demonstrate structural damage to the kidney and at time points earlier than increases in serum creatinine measurements allow. Over the past 10 years, there have been 3300 new publications and hundreds of new biomarkers investigated, yet concern still remains regarding AKI biomarker performance. The AKI biomarkers are yet to be widely utilized in clinical practice, leading some to question whether AKI biomarkers will ever reach their initial promise. However, we believe that biomarkers are an important part of current and future AKI research and clinical management. In this review, we compare the historical contexts of acute myocardial ischemia and AKI biomarker development to illustrate the progress that has been made within AKI biomarker research in a relatively short period of time and also to point out key differences between the disease processes that have been barriers to widespread AKI biomarker adoption. Finally, we discuss potential paths by which biomarkers can lead to appropriate AKI treatment responses that lower morbidity and mortality.Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the prevention and treatment of the disease. A lack of efficacy in drug trials led to the concern that AKI was not being diagnosed early enough for an effective intervention and that a rise in serum creatinine itself is not a sensitive-enough marker. Researchers have been searching for novel biomarkers that can not only assess a decline in kidney function but also demonstrate structural damage to the kidney and at time points earlier than increases in serum creatinine measurements allow. Over the past 10 years, there have been 3300 new publications and hundreds of new biomarkers investigated, yet concern still remains regarding AKI biomarker performance. The AKI biomarkers are yet to be widely utilized in clinical practice, leading some to question whether AKI biomarkers will ever reach their initial promise. However, we believe that biomarkers are an important part of current and future AKI research and clinical management. In this review, we compare the historical contexts of acute myocardial ischemia and AKI biomarker development to illustrate the progress that has been made within AKI biomarker research in a relatively short period of time and also to point out key differences between the disease processes that have been barriers to widespread AKI biomarker adoption. Finally, we discuss potential paths by which biomarkers can lead to appropriate AKI treatment responses that lower morbidity and mortality. Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the prevention and treatment of the disease. A lack of efficacy in drug trials led to the concern that AKI was not being diagnosed early enough for an effective intervention and that a rise in serum creatinine itself is not a sensitive-enough marker. Researchers have been searching for novel biomarkers that can not only assess a decline in kidney function but also demonstrate structural damage to the kidney and at time points earlier than increases in serum creatinine measurements allow. Over the past 10 years, there have been 3300 new publications and hundreds of new biomarkers investigated, yet concern still remains regarding AKI biomarker performance. The AKI biomarkers are yet to be widely utilized in clinical practice, leading some to question whether AKI biomarkers will ever reach their initial promise. However, we believe that biomarkers are an important part of current and future AKI research and clinical management. In this review, we compare the historical contexts of acute myocardial ischemia and AKI biomarker development to illustrate the progress that has been made within AKI biomarker research in a relatively short period of time and also to point out key differences between the disease processes that have been barriers to widespread AKI biomarker adoption. Finally, we discuss potential paths by which biomarkers can lead to appropriate AKI treatment responses that lower morbidity and mortality. |
| Author | Faubel, Sarah Gist, Katja M Griffin, Benjamin R |
| Author_xml | – sequence: 1 givenname: Benjamin R surname: Griffin fullname: Griffin, Benjamin R organization: Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA – sequence: 2 givenname: Katja M surname: Gist fullname: Gist, Katja M organization: Department of Pediatrics, The Heart Institute, University of Colorado, Aurora, CO, USA – sequence: 3 givenname: Sarah surname: Faubel fullname: Faubel, Sarah organization: Renal Section, Veterans Affairs Eastern Colorado Health Care System, Denver, CO, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30654681$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3389_fphar_2021_798642 crossref_primary_10_1007_s10157_022_02300_2 crossref_primary_10_34067_KID_0003552020 crossref_primary_10_1038_s41581_020_0276_7 crossref_primary_10_1186_s12967_022_03687_y crossref_primary_10_1016_j_cllc_2022_01_003 crossref_primary_10_1053_j_jvca_2024_07_016 crossref_primary_10_1128_AAC_01650_19 crossref_primary_10_1136_bmjopen_2020_046274 crossref_primary_10_3390_cells13191613 crossref_primary_10_1007_s40140_019_00325_0 crossref_primary_10_3390_nu11092087 crossref_primary_10_1371_journal_pone_0316205 crossref_primary_10_1080_0886022X_2023_2205958 crossref_primary_10_3389_fphys_2020_00139 crossref_primary_10_3390_jcm13226720 crossref_primary_10_1371_journal_pone_0311755 crossref_primary_10_5005_jp_journals_10071_23398 crossref_primary_10_1002_prp2_695 crossref_primary_10_1038_s41390_022_02269_4 |
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| SubjectTerms | Acute Kidney Injury - diagnosis Acute Kidney Injury - history Biomarkers - analysis History, 20th Century Humans Kidney Function Tests - history |
| Title | Current Status of Novel Biomarkers for the Diagnosis of Acute Kidney Injury: A Historical Perspective |
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