Recent
improvements in our understanding of AKI have enabled us to better recognize
and identify early changes within the spectrum of kidney injury. AKI is
prevalent among urological patients and carries significant clinical and
financial costs. The previous lack of consensus about the classification of ARF
and limited diagnostic tools to identify early renal dysfunction impeded
research and development of early prevention and treatment strategies for AKI.
The longstanding need for earlier and more reliable detection of AKI has led to
the discovery of promising biomarkers for AKI, such as NGAL, IL-18, cystatin C,
and KIM-1, which have the potential to be analogous to troponins in the
management of cardiac ischemia. In the future, these novel biomarkers will
likely prove invaluable for the prevention and clinical management of AKI.
Partial nephrectomy serves as an excellent paradigm for the potential use of
these biomarkers, although there are several other urological disease processes
that are often associated with AKI that will also likely be transformed by this
new biotechnology. Although recent results have been robust, further validation
of these biomarkers in a variety of clinical settings will be required before
wider implementation.
UROLOGY 77: 5–11, 2011. © 2011 Elsevier Inc.
