Biomarkers, diagnosis and management of sepsis-induced acute kidney injury: a narrative review

Sepsis is a leading cause of acute kidney injury in clinical practice. The diagnosis of sepsis-induced acute kidney injury requires the diagnosis of sepsis and subsequent occurrence of acute kidney injury. The current definition for acute kidney injury is based on Scr and urine output, which is limited by the delayed identification of such patients. Numerous novel biomarkers have been found to be up-regulated in kidney injury, among which cystatin C and neutrophil gelatinase-associated lipocalin are the most studied. In the management of sepsis-induced acute kidney injury, early goal directed therapy may be potentially useful, but requires further validation in large clinical trials. It is well known that fluid overload is harmful in septic patients with established acute kidney injury and should be avoided. Renal replacement therapy is the mainstay treatment for the severe form of sepsis-induced acute kidney injury. However, there is still no consensus on the definition of timing and dosing in clinical practice, and the optimal timing and dosing are still unknown.