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Acute kidney injury: from clinical to molecular diagnosis

The RIFLE classification was introduced in 2004 to describe the presence of acute kidney injury (AKI) and to define its clinical stage, based upon the serum creatinine level and urine output. The same criteria, although slightly modified, are used in the other scoring systems AKIN and KDIGO. Mortali...

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Autor principal: Ronco, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936182/
https://www.ncbi.nlm.nih.gov/pubmed/27384344
http://dx.doi.org/10.1186/s13054-016-1373-7
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author Ronco, Claudio
author_facet Ronco, Claudio
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description The RIFLE classification was introduced in 2004 to describe the presence of acute kidney injury (AKI) and to define its clinical stage, based upon the serum creatinine level and urine output. The same criteria, although slightly modified, are used in the other scoring systems AKIN and KDIGO. Mortality and morbidity remain high in AKI, suggesting that current diagnostic methods are suboptimal, poorly accurate, and often timely inadequate in detecting the presence of early kidney injury. Conversely, a growing body of evidence indicates that new AKI biomarkers can be used to both rule out AKI and to assess high-risk conditions or the presence of subclinical forms. Neutrophil gelatinase-associated lipocalin or cell cycle arrest biomarkers seem to be sensitive and specific enough to be used in conjunction with existing markers of AKI for better classifying renal injury as well as dysfunction. Improvements in diagnosis, risk identification, stratification, prognosis, and therapeutic monitoring may improve prevention and protection from organ damage and help to identify patients at risk, allowing individualized therapy. In this view, we may say that AKI diagnosis has finally moved from clinical to molecular level with potential benefits for the patients because similar progress has been shown in other disciplines.
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spelling pubmed-49361822016-07-07 Acute kidney injury: from clinical to molecular diagnosis Ronco, Claudio Crit Care Commentary The RIFLE classification was introduced in 2004 to describe the presence of acute kidney injury (AKI) and to define its clinical stage, based upon the serum creatinine level and urine output. The same criteria, although slightly modified, are used in the other scoring systems AKIN and KDIGO. Mortality and morbidity remain high in AKI, suggesting that current diagnostic methods are suboptimal, poorly accurate, and often timely inadequate in detecting the presence of early kidney injury. Conversely, a growing body of evidence indicates that new AKI biomarkers can be used to both rule out AKI and to assess high-risk conditions or the presence of subclinical forms. Neutrophil gelatinase-associated lipocalin or cell cycle arrest biomarkers seem to be sensitive and specific enough to be used in conjunction with existing markers of AKI for better classifying renal injury as well as dysfunction. Improvements in diagnosis, risk identification, stratification, prognosis, and therapeutic monitoring may improve prevention and protection from organ damage and help to identify patients at risk, allowing individualized therapy. In this view, we may say that AKI diagnosis has finally moved from clinical to molecular level with potential benefits for the patients because similar progress has been shown in other disciplines. BioMed Central 2016-07-07 2016 /pmc/articles/PMC4936182/ /pubmed/27384344 http://dx.doi.org/10.1186/s13054-016-1373-7 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Commentary
Ronco, Claudio
Acute kidney injury: from clinical to molecular diagnosis
title Acute kidney injury: from clinical to molecular diagnosis
title_full Acute kidney injury: from clinical to molecular diagnosis
title_fullStr Acute kidney injury: from clinical to molecular diagnosis
title_full_unstemmed Acute kidney injury: from clinical to molecular diagnosis
title_short Acute kidney injury: from clinical to molecular diagnosis
title_sort acute kidney injury: from clinical to molecular diagnosis
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936182/
https://www.ncbi.nlm.nih.gov/pubmed/27384344
http://dx.doi.org/10.1186/s13054-016-1373-7
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