Soluble urokinase plasminogen activator receptor (suPAR) |
Serum biomarker detected in body fluids like blood, urine, peritoneal fluids, and cerebrospinal fluids |
- Preoperative detection of AKI - suPAR is a more sensitive detector than serum creatinine as suPAR levels are elevated in AKI patients when creatinine levels are not |
- A reliable cutoff value for suPAR levels was not determined |
Neutrophil gelatinase-associated lipocalin (NGAL) |
NGAL is an iron-transporting glycoprotein which gathers in the kidney tubules and urine after nephrotoxic and ischemic insult |
- Levels increase rapidly after renal ischemia-reperfusion injury - Renoprotective role in regeneration of kidney tubule |
- Influenced by non-renal factors such as age, anaemia, cancer, CKD, and inflammatory conditions - Urine sample difficult to obtain in patients with severe oliguria |
Interleukin-18 |
24kDa precursor, produced by various tissues such as monocytes, macrophages, and proximal tubular epithelial cells |
- Biomarker with risk stratification potential, assist with stratification of patients based on severity of AKI - Mediator of ischemic reperfusion injury |
- Urine sample difficult to obtain in patients with severe oliguria - Induces inflammation of kidney tubule |
Galectin-3 |
Beta-galactoside-binding lectin, which is a regulator of inflammation and tissue fibrosis |
- Preoperative detection of AKI |
- Associated with renal fibrosis |
Tissue inhibitor of metalloproteinases-2 (TIMP2) and insulin-like growth factor binding protein 7 (IGFBP7) |
Soluble protein expressed by kidney involved in cell-cycle arrest during earliest phases of cellular stress and tubular injury |
- Risk stratification of patients into high and low risk can be done, it is a better risk stratification than standard clinical assessment |
- Oliguria impedes urine sampling of TIMP2 and IGFBP7 - There is an association between elevated CCABs and diabetes which might reflect subclinical, subacute, or chronic diabetesassociated renal injury and create a major cofounder to the predictive value for CSA-AKI |
Kidney injury molecule-1 (KIM-1) |
Immunoglobulin superfamily transmembrane receptor expressed in tubular kidney injury to help in removal of necrotic and apoptotic debris |
- Urinary KIM-1 increased rapidly in models of ischemic AKI |
- Influenced by non-renal factors such as sepsis, contrast media, age, diabetes mellitus, hypertension, and atherosclerosis - Role in carcinogenesis of renal cell carcinoma |
Netrin-1 |
Small protein which plays an important role in formation of new blood vessels, cell adhesion, and tumorigenesis |
- Protective role in promotion of kidney epithelial cell proliferation and inhibition of apoptosis |
- High in patients with ischemia, contrast agents, drugs, and sepsis, hence, association with AKI might not be independent |
Growth-differentiation factor-15 |
Expressed in many organs such as heart, lung, liver, and intestines, and is an independent predictor of postoperative renal dysfunction |
- Preoperative detection - Superior predictive ability compared to risk scores such as EuroSCORE |
- Marker is also associated with mortality and morbidity, hence, association with AKI might not independent |