Which biomarker provides the earliest detection of acute kidney injury?

Acute kidney injury (AKI) is a common complication among ICU patients and its incidence has been increasing in recent years. Currently the diagnosis of AKI requires serial assessment of laboratory tests over a period of several days, and is based mainly on serum creatinine (sCr) as supported by Risk, Injury, Failure, Loss, and End-Stage Kidney Disease (RIFLE) criteria. As a consequence, the use of biomarkers of acute kidney damage could be of great utility at the time of ICU admission in order to distinguish AKI from volume responsive renal dysfunction, chronic kidney disease (CKD) or normal renal function.

Neutrophil gelatinase-associated lipocalin (NGAL) is expressed in immature neutrophil precursors and in epithelial cells during both inflammation and neoplastic transformation.

Neutrophil gelatinase-associated lipocalin (NGAL) is a promising novel biomarker that correlates with the severity and outcome of acute kidney injury (AKI).