الفهرس | Only 14 pages are availabe for public view |
Abstract In 2002, the Acute Dialysis Quality Initiative (ADQI) group proposed a standard definition and classification system for the syndrome of acute renal failure through a broad consensus of experts across disciplines and international boundaries. The classification system coins the acronym RIFLE and has three levels: Risk, Injury, and Failure; and two outcomes: persistent acute renal failure (termed Loss) and End stage kidney disease (Uchino et al., 2006). Classically, the causes of AKI have been subdivided into three groups: prerenal, intrinsic, and post renal. While there is considerable overlap between these, especially the first two, it remains a useful clinical guide Current diagnostic paradigms for AKI are limited by reliance on serum creatinine, which is affected by age, gender and muscle mass. In addition, elevations in serum creatinine may occur several days after the actual injury. The search for AKI biomarkers has focused on identifying alternatives to serum creatinine. Urinary neutrophil gelatinase associated lipocalin (NGAL) and interleukin-18 may provide insights into the cause of AKI 9 (Nickolas et al., 2008). Similarly, urinary and serum NGAL, serum cystatin C and urinary kidney injury molecule-1 (KIM-1) may facilitate the early diagnosis of AKI. KIM-1 also shows promise in predicting adverse events in patients with established AKI (Liangos et al., 2007). Ongoing studies are clarifying the role of these biomarkers in larger patient cohorts. Ultimately, it will need to be shown that |