Novel biomarkers of acute kidney injury in children: an update on recent findings

医学 急性肾损伤 塔姆-霍斯法尔蛋白 脂质运载蛋白 肌酐 来复枪 急性肾小管坏死 生物标志物 重症监护医学 生物信息学 内科学 泌尿系统 考古 化学 历史 生物 生物化学
作者
Ibrahim Sandokji,Jason H. Greenberg
出处
期刊:Current Opinion in Pediatrics [Ovid Technologies (Wolters Kluwer)]
卷期号:32 (3): 354-359 被引量:29
标识
DOI:10.1097/mop.0000000000000891
摘要

The clinical diagnosis of acute kidney injury (AKI) relies largely on changes in serum creatinine; a delayed biomarker. Research in children has been focused on developing novel AKI biomarkers, which can improve the prediction, early detection and diagnosis of kidney injury, as well as our understanding of AKI pathophysiology. In this review, we describe recently published studies on urine or blood biomarkers of AKI. The mechanistic relevance of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, interleukin (IL)-18, liver-type fatty acid binding protein, tissue inhibitor of metalloproteinase (TIMP)-2/insulin-like growth factor-binding protein (IGFBP)-7, uromodulin, as well as other inflammatory biomarkers are discussed in the context of AKI pathophysiology, as well as their performance predicting or diagnosing AKI.Biomarkers of tubular injury, cell cycle arrest and inflammation are presented in this review. NGAL continues to be the most frequently studied biomarker and continues to have good performance in a variety of clinical settings, most notably after cardiopulmonary bypass. We also found promising results with less studied biomarkers for the prediction of AKI in children, including TIMP2, IGFBP7, uromodulin, tumor necrosis factor-α and IL-8.Identifying new AKI biomarkers is a priority in pediatric nephrology research because of the morbidity associated with AKI, as well as the lack of therapies for AKI. Recent research suggests that novel AKI biomarkers have the potential to predict the development of AKI and diagnose AKI earlier than changes in serum creatinine. The diverse causes of AKI, the different settings where patients develop AKI and the changing biomarker reference ranges throughout childhood remain challenges in biomarker development.
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