Biomarkers of Acute Renal Failure

Conclusions

August 2009

In conclusion, acute kidney injury is a significant public health problem with large morbidity and mortality, as well as health care cost. The current clinical tests such as serum creatinine do not allow early detection of cases, at a time when interventions might have the biggest effect to prevent the development of full-blown acute kidney injury. For this purpose, urinary biomarkers under development show great promise. Of these, NGAL has the most extensive literature to date. However, it is likely that other biomarkers will also prove useful in this rapidly evolving area. Longer term, it will be important to perform clinical outcome studies using the most useful biomarkers. Only then will we be able to prove the hypothesis that early detection of kidney injury and rapid initiation of therapy actually will improve patient outcomes, which is obviously our primary objective.

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Jump to section:

• Introduction
• Acute Kidney Injury
• Common Causes of Acute
• Progression From Pre-renal to Acute Tubular Necrosis
• Towards a Kidney Troponin
• Origin of Formed Elements in Urinalysis
• Urinanalysis: A Traditional Biomarker of AKI
• Hyaline Casts
• Renal Epithelial Cell Cast
• Leukocyte Cast
• RBC Cast
• Pigmented Cast
• Granular Cast
• Other Helpful Indices
• Potential Sources of Urinary Biomarkers
• NGAL as a Biomarker
• Studies Support NGAL as a Biomarker of AKI in the Following Situations
• Mayo Renal Laboratory Urinary NGAL Normals
• Normal Urinary NGAL Levels are Not Dependent on Age, but are Higher in Women than Men
• Ongoing Mayo Clinic Clinical Validation Study
• Ongoing Mayo Clinic Clinical Validation Study: Preliminary Results
• Study
• Other Potential Markers on the Horizon
• Mayo Clinic Goals
• Conclusions
• References
• Questions?