Is there any role of serum or urine biomarkers in detecting Sepsis associated acute kidney injury?
A concern among nephrologists has been that rises in serum creatinine occur relatively late (at least 24 to 48 hours) after the kidney injury from sepsis or other causes.
This late diagnosis may compromise the ability of clinicians to rapidly intervene with strategies that could protect the kidneys from further damage.
Thus, a series of serum and urine biomarkers that can detect early stages of small degrees of kidney injury have been investigated.
Only one panel of urine biomarkers has yet to meet Federal Drug Administration (FDA) approval criteria for risk stratification of patients for acute kidney injury: a combination of urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein-7.
A combination level of these two biomarkers has a relatively strong predictive ability to tell whether a patient will develop moderate to severe acute kidney injury within 12 hours.
However, it is not yet known whether care protocols based upon this risk score will lead to improved outcomes, and the routine use of biomarkers for the detection of early acute kidney injury has not yet gained clinical acceptance.
