Anest. intenziv. Med. 2011;22(1):23-27

New biomarkers in the diagnosis of renal dysfunctionIntesive Care Medicine - Review Article

Gerlichová Monika^1,*, Živný Pavel², Matějovič Martin³, Černý Vladimír¹

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, LF v Hradci Králové a Fakultní nemocnice Hradec Králové

² Ústav klinické biochemie a diagnostiky, Univerzita Karlova v Praze, LF v Hradci Králové a Fakultní nemocnice Hradec Králové

³ I. interní klinika - JIP, Univerzita Karlova v Praze, LF v Plzni, Fakultní nemocnice Plzeň

The introduction of new preventive and therapeutic interventions in the treatment of acute kidney injury depends on its early diagnosis. For this reason the priority is to search for markers that can indicate renal dysfunction earlier than the reduction in glomerular filtration rate with a subsequent increase in the serum creatinine levels and a decrease in diuresis.
Clinical research in various patient subpopulations (intensive care, cardiac surgery, transplanr surgery) is going on, yet without clear recommendation for clinical practice. Neutrophil gelatinase-associated lipocalin (NGAL) is one the most promising biomarkers of renal injury, detectable in plasma and urine within 2-4 hours after insult. Its good diagnostic and prognostic value was confirmed in meta-analysis of 19 clinical studies including 2 500 patients. NGAL is elevated in various forms of acute and chronic kidney injuries. For this reason, it should be ferther used in combination with other markers (interleukin-18 and kidney injury molecule-1) for more specific diagnosis.

Keywords: acute kidney injury; tubular damage; early markers of renal dysfunction; neutrophil gelatinase-associated lipocalin; interleukin 18; kidney injury molecule-1

Received: March 15, 2010; Accepted: November 8, 2010; Published: February 1, 2011  Show citation