How biomarkers may improve the current approach to AKI

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How biomarkers may improve the current approach to AKI How biomarkers may improve the current approach to AKI. The top panel illustrates the current paradigm highlighting how serum creatinine does permit recognition of AKI, albeit delayed, and an estimate of severity based on loss of function. How biomarkers may improve the current approach to AKI. The top panel illustrates the current paradigm highlighting how serum creatinine does permit recognition of AKI, albeit delayed, and an estimate of severity based on loss of function. However, much is left to clinical impression, including its anatomic location, etiology, appropriateness for a trial, the presence and extent of tissue damage, and risk of progression. Similarly, tissue damage is presumed retrospectively only after loss of function becomes persistent and prospects for recovery often remain uncertain. The lower panel shows the complementary roles that AKI biomarkers may play, including aiding in detection of subclinical/early injury, providing information on its type and location with potential applications including as a tool for trial enrollment, detailing the extent of damage, as a beacon for ongoing injury during recovery or indicating repair/fibrosis, and risk stratifying for future complications. CV, cardiovascular, HTN, hypertension, sCR, serum creatinine. Rakesh Malhotra, and Edward D. Siew CJASN 2017;12:149-173 ©2017 by American Society of Nephrology