Biomarkers for Diagnosis and Prognosis of AKI in Children: One Size Does Not Fit All

Clin J Am Soc Nephrol. 2017 Sep 7;12(9):1551-1557. doi: 10.2215/CJN.12851216. Epub 2017 Jun 30.

Abstract

Pediatric AKI has become a significant health concern due to its rising incidence and association with adverse outcomes. Because of the limitations of serum creatinine, ongoing research has evaluated multiple novel biomarkers for the early detection of AKI. Identifying biomarkers that precede changes in serum creatinine is vital, because these biomarkers provide opportunities to improve outcomes through early diagnosis and timely disease management. In this review, we discuss salient findings on 16 candidate biomarkers and their association with AKI. We explore the differences in biomarker distribution by age and discuss why adult biomarker research findings cannot be directly extrapolated to children. With future research, more consideration needs to be given to how the maturing kidney affects biomarker levels and how we interpret biomarker performance in children. A comprehensive approach using age-specific biomarker reference ranges is required to develop pediatric biomarkers and improve outcomes for children with kidney disease.

Keywords: Epidemiology and outcomes; acute renal failure; albuminuria; kidney development; pediatric intensive care medicine; pediatric nephrology.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / urine*
  • Adolescent
  • Adult
  • Age Factors
  • Biomarkers / blood*
  • Biomarkers / urine*
  • Child
  • Child, Preschool
  • Creatinine / blood
  • Humans
  • Infant
  • Infant, Newborn
  • Kidney / metabolism*
  • Kidney / physiopathology
  • Kidney Function Tests* / standards
  • Predictive Value of Tests
  • Reference Values
  • Reproducibility of Results

Substances

  • Biomarkers
  • Creatinine