Despite the recent findings concerning pathogenesis and novel
therapeutic strategies, the mortality rate in patients with acute kidney injury
(AKI) remains very high. Early detection of patients with impaired renal
function may help to ensure more aggresive treatment and to improve clinical
outcome. Serum creatinine is still gold standard of kidney injury, although it is
well known as an insensitive and unreliable biomarker (for example, its
concentration does not increase significantly until about half of the kidney
function is lost). Considering these data, researches and clinicians are making
great efforts in the past decade in order to discover and validate novel AKI
biomarkers. Kidney injury molecule-1 (KIM-1), Neutrophil gelatinase-associated
lipocalin (NGAL), Interleukin-18 (IL-18), Cystatin C (Cys-C) are some of new, promising
markers of kidney damage which are currently in the focus of preclinical and clinical studies.
Recent data suggest that some of these new biomarkers represent important parametars of
acute tubular necrosis (ATN) and reliable predictors of development and prognosis of AKI. Beside
that, monitoring of these markers could have significant importance for early diagnosis and
clinical course, not only in patients with various forms of AKI and other renal diseases, but also
in patients with cardiorenal syndrome, heart failure, cardiopulmonary bypass, cardiothoracical
surgical interventions, in the pediatric emergency setting etc.
The aim of this review is to summarize the literature data concerning some new biomarkers,
evaluate their role as well as their limitations in the early diagnosis and predict clinical outcome
of some renal diseases.