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La Rivista Italiana della Medicina di Laboratorio 2019 Dicembre;15(4):263-76

DOI: 10.23736/S1825-859X.19.00041-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: Italian

Acute kidney injury (AKI) biomarkers. Part two: traditional, new and potential biomarkers of AKI

Maria GOLATO ¹ ✉, Sabino MATERA ¹, Gianna IMPICCIATORE ²

¹ Patologia Clinica, Ospedale Clinicizzato S.S. Annunziata, Chieti, Italia; ² Ginecologia e Ostetricia, P.O. S. Timoteo ASREM, Termoli, Campobasso, Italia

In the first part of this review on acute kidney injury (AKI), we showed that it is a complex syndrome with a multifactorial etiology and with a high mortality and morbidity rate if not diagnosed early and that it needs biomarkers for an early diagnosis to avoid short and long-term complications. Nowadays, in the clinical practice, a large number of biomarkers exists and there are several studies in the literature that evaluated their specificity and sensitivity for renal damage with controversial results. Nevertheless, the desired goal of identifying a “renal troponin” has not yet been reached. In this second part of the review of the literature, we have tried to summarize how the laboratory is useful in the diagnosis of AKI by reviewing several well-known (serum creatinine, diuresis, glomerular filtration rate), new (NGAL, interleukin 18, KIM 1, cystatin C, NAG, L-FABP, TIMP 2 e IGFB-7), and potential (calprotectin, angiotensinogen, micro-RNAs, netrin-1) biomarkers. For each of them, the limits and the values of sensitivity and specificity, their possible use in the clinical setting, the ambitious goals that have not yet been achieved, and the literature algorithms have been highlighted.

KEY WORDS: Biomarkers; Acute kidney injury; Kidney diseases