Pickering JW, Endre ZH. Challenges facing early detection of acute kidney injury in the critically ill. World J Crit Care Med 2012; 1(3): 61-66 [PMID: 24701403 DOI: 10.5492/wjccm.v1.i3.61]
Corresponding Author of This Article
Dr. John Pickering, PhD, Christchurch Kidney Research Group, Department of Medicine, University of Otago, PO Box 4345,Christchurch 8140, New Zealand. john.pickering@otago.ac.nz
Article-Type of This Article
Editorial
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World J Crit Care Med. Jun 4, 2012; 1(3): 61-66 Published online Jun 4, 2012. doi: 10.5492/wjccm.v1.i3.61
Challenges facing early detection of acute kidney injury in the critically ill
John W Pickering, Zoltán H Endre
John W Pickering, Zoltán H Endre, Christchurch Kidney Research Group, Department of Medicine, University of Otago, Christchurch 8140, New Zealand
Zoltán H Endre, Department of Nephrology, Prince of Wales Clinical School, University of New South Wales, Sydney NSW 2052, Australia
Author contributions: Pickering JW and Endre ZH provided concept; Pickering JW made first draft; Pickering JW and Endre ZH co-ordinated and provided final draft.
Supported by Grants from the Australian and New Zealand Society of Nephrology Infrastructure and Enabling and the Marsden Fund Council from Government funding, administered by the Royal Society of New Zealand
Correspondence to: Dr. John Pickering, PhD, Christchurch Kidney Research Group, Department of Medicine, University of Otago, PO Box 4345,Christchurch 8140, New Zealand. john.pickering@otago.ac.nz
Telephone: +64-3-3641847 Fax: +64-3-3640935
Received: September 16, 2011 Revised: October 10, 2011 Accepted: May 25, 2012 Published online: June 4, 2012
Abstract
Recent advances in the detection of acute kidney injury (AKI) afford the possibility of early intervention. Proteomics and genomics have identified many markers of tubular cell injury, some of which are manifest in the urine. One trial has used novel injury biomarkers to recruit patients to an intervention prior to an elevation in plasma creatinine. This trial and other recent studies have shown that the use of biomarkers of injury will depend on the time the patient presents following insult to the kidney, the likely cause of that insult, and the pre-injury renal function of that patient. The definition of AKI is likely to change in the near future to include a measure of injury. We anticipate novel therapies becoming available following successful trials that utilize the methodology of early intervention following an elevated injury biomarker.
