Published online May 6, 2015. doi: 10.5527/wjn.v4.i2.160
Peer-review started: July 17, 2014
First decision: August 14, 2014
Revised: December 30, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: May 6, 2015
Patients undergoing urologic surgery are at risk of acute kidney injury (AKI) and consequently long-term deterioration in renal function. AKI is further associated with significantly higher odds of perioperative complications, prolonged hospital stay, higher mortality and costs. Therefore, better awareness and detection of AKI, as well as identification of AKI determinants in the urological surgery setting is warranted to pre-empt and mitigate further deterioration of renal function in patients at special risk. New consensus criteria provide precise definitions of diagnosis and description of the severity of AKI. However, they rely on serum creatinine (SCr), which is known to be an inaccurate marker of early changes in renal function. Therefore, several new urinary and serum biomarkers promise to address the gap associated with the use of SCr. Novel biomarkers may complement SCr measurement or most likely improve the diagnostic accuracy of AKI when used in combinations. However, novel biomarkers have to prove their clinical applicability, accuracy, and cost effectiveness prior to implementation into clinical practice. Most preferably, novel biomarkers should help to positively improve a patient’s long-term renal functional outcomes. The purpose of this review is to discuss currently available biomarkers and to review their clinical evidence within urologic surgery settings.
Core tip: Patients undergoing renal surgery represent a unique population at risk of acute kidney injury (AKI). AKI is known to be associated with adverse perioperative outcomes. Therefore, efforts are warranted to promote awareness for AKI. Novel biomarkers promise to improve early and accurate detection of AKI, which may help to provide better patients’ outcomes. However, these biomarkers still have to prove their clinical effectiveness prior to their implementation into urologic surgery settings.