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Arch Hellen Med, 29(5), September-October 2012, 550-561


Acute kidney injury and novel markers of renal function in adult intensive care unit patients

S. Kokkoris,1 E. Grapsa,2 S. Nanas1
1First Critical Care Clinic, Medical School, University of Athens, "Evangelismos" General Hospital, Athens,
2Department of Nephrology, Medical School, University of Athens, "Areteio" General Hospital, Athens, Greece

Acute kidney damage is one of the most common problems in the critically ill patients hospitalized in the intensive care unit (ICU) and it is well established that impaired renal function increases morbidity and mortality in these patients. Despite the technological and pharmaceutical advances made during recent decades, both the incidence (1−25%) and the mortality (50−80%) associated with acute kidney injury in these critically ill patients remain unchanged. Creatinine, which is the primary biomarker of renal dysfunction in use to date, has many disadvantages, such as the time delay in its increase in the serum, and the influence of other factors on its level, such as age, gender, muscle mass, etc. Hence, there is a need for identification of better renal biomarkers in order to provide timely intervention for prevention and treatment of acute kidney damage. The lack of an early biomarker is an obstacle to the development of new acute kidney injury prevention strategies. With the incidence of acute kidney injury reaching epidemic dimensions, the need for novel markers is urgent, and in recent years research directed at finding biomarkers has been intense. Two such promising biomarkers are neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC). This is a review of the studies which have tested the predictive capability of these two markers, in urine and/or plasma, for the early detection of acute kidney damage in the mixed adult ICU population.

Key words: Acute kidney injury, Biomarkers, CysC, ICU, NGAL.

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