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Highly Accessed Review

Clinical review: Biomarkers of acute kidney injury: where are we now?

Marlies Ostermann1*, Barbara J Philips2 and Lui G Forni3

Author Affiliations

1 King's College London, Guy's and St Thomas' Hospital, Department of Critical Care and Nephrology, London SE1 7EH, UK

2 St George's Healthcare Trust, St George's Hospital, Department of Critical Care, London SW17 0QT, UK

3 Western Sussex Hospitals Trust, Department of Critical Care, Worthing, West Sussex, BN11 2DH, UK

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Critical Care 2012, 16:233  doi:10.1186/cc11380

Published: 21 September 2012

Abstract

The recognition that acute kidney injury (AKI) is a significant independent risk factor for morbidity and mortality has resulted in a substantial number of publications over the past 5 years or more. In no small part these have, to a degree, highlighted the inadequacy of conventional markers of renal insufficiency in the acute setting. Much effort has been invested in the identification of early, specific AKI markers in order to aid early diagnosis of AKI and hopefully improve outcome. The search for a 'biomarker' of AKI has seen early promise replaced by a degree of pessimism due to the lack of a clear candidate molecule and variability of results. We outline the major studies described to date as well as discuss potential reasons for the discrepancies observed and suggest that evolution of the field may result in success with ultimately an improvement in patient outcomes.