DOI: 10.36347/sajb.2016.v04i02.002

Pages: 100-105

Diseases of the kidney are diverse, ranging from Acute Kidney Injury (AKI) to End Stage Renal Disease (ESRD). The treatment of kidney disease poses a major challenge to the health care system and the global economy. Hence the detection and management of kidney diseases in the early, reversible and potentially treatable stages is of paramount importance. AKI refers to a syndrome that results from multiple causative factors and occurs in a variety of clinical settings. AKI presents with varied clinical manifestations that range from a minimal elevation in serum creatinine to anuria. AKI is largely asymptomatic and establishing the diagnosis relies on functional biomarkers such as serial serum creatinine measurements. Unfortunately, serum creatinine is a delayed and unreliable indicator of AKI due to various reasons. Serum creatinine does not accurately depict kidney function until a steady state has been reached which could take several days. Animal studies have identified interventions that can prevent and/ or treat AKI if identified early in the course of disease, even before the serum creatinine begins to rise. The paucity of early biomarkers has hampered our ability to translate these promising therapies to human AKI. Also lacking are reliable methods to assess the efficacy of protective or therapeutic interventions and early predictive biomarkers of drug toxicity. The pursuit of improved biomarkers for the early diagnosis of AKI and its outcome is an area of intense contemporary research. Understanding the early stress response of the kidney to acute injury has revealed a number of potential biomarkers. Some of the biomarkers are Neutrophil Gelatinase Associated Lipocalin (NGAL) , Cystatin C, Interleukin-18 (IL-18) , Liver type Fatty Acid Binding Protein(L-FABP) , Kidney Injury Molecule – 1 (KIM-1) etc.