Volume 13 Issue 8
Serum and Urinary Biomarkers for Predicting Outcomes in Acute Kidney Injury Patients
1Dr Rizwan Munir, 2Dr Muhammad Shaukat, 3Dr. Fazal Muhammad, 4Hafiz Furqan Ahmad, 5Dr Javaid Akhtar Hashmi , 6Prof Dr Ghulam Abbas
1Associate Consultant Nephrologist King Saud Medical City Riyadh.
2 Assistant professor Neprology. Gomal Medical College Dera Ismail Khan & DHQr Teaching Hospital Dera Ismail Khan KPK.
3Assistant Professor Head of Nephrology Department. Baluchistan institute of Nephro urology Quetta.
4FCPS in Nephrology Hbs general hospital, Islamabad.
5Assistant Professor Community Medicine Shahida Islam Medical and Dental college Lodhran.
6Professor of Nephrology Nishtar medical university Multan.
Abstract
Background:Acute Kidney Injury (AKI) remains a major clinical burden in hospitalized patients, particularly in intensive care units, where delayed diagnosis often results in poor outcomes. Traditional markers such as serum creatinine and urine output are suboptimal for early detection due to their insensitivity and late response to renal injury.
Aim:To review and evaluate the diagnostic performance of emerging blood and urinary biomarkers for early detection of AKI in hospitalized patients, with emphasis on their sensitivity, specificity, clinical applicability, and time to diagnosis.
Methods:This narrative review includes data from published studies between 2015 and 2024 retrieved from PubMed, Scopus, and Web of Science. In addition, a randomized hospital-based sample of 30 patients from Urology and Nephrology departments was analyzed for validation. Biomarkers such as NGAL, KIM-1, Cystatin C, and TIMP-2·IGFBP7 were compared with serum creatinine levels. The collected data were statistically tested using SPSS (v26) for descriptive and inferential analysis, and SmartPLS (v4) for structural modeling and predictor validation.
Results:Among the evaluated biomarkers, urinary NGAL and TIMP-2·IGFBP7 demonstrated the highest diagnostic performance, with pooled sensitivities exceeding 85% and AUC values between 0.80–0.92. In the randomized sample, NGAL and KIM-1 levels were significantly higher in AKI-confirmed patients (p<0.01). TIMP-2·IGFBP7 accurately predicted renal insult up to 24 hours prior to creatinine elevation. SPSS and SmartPLS validated the predictive value of these markers with R² > 0.72.
Conclusion:Novel biomarkers offer significant potential for early AKI detection in hospitalized patients, outperforming traditional methods. Integration of these markers into clinical workflows could improve patient outcomes through earlier intervention. Further validation in multicenter, high-risk cohorts is warranted.
Keywords:Acute Kidney Injury, Biomarkers, NGAL, TIMP-2, KIM-1, Cystatin C, Early Diagnosis, SPSS, SmartPLS
