NephroCheck at 10: addressing unmet needs in AKI diagnosis and risk stratification

Abstract Despite its name, the current diagnosis of acute kidney injury (AKI) still depends on markers decreased function and not injury. This results in a delayed diagnosis: AKI is diagnosed based serum creatinine criteria only when severity enough to decrease glomerular filtration rate. Moreover, by time diagnosed, insult may have already ceased, even appropriate therapy targeted at specific associated pathogenic pathways no longer be effective. Biomarkers are needed that allow criteria. At least three commercially available immunoassays assessing urinary or plasma neutrophil gelatinase-associated lipocalin (NGAL) [TIMP2]*[IGFBP7] (NephroCheck®) generated promising data regarding prediction early AKI, although their relative performance depend clinical context. Recently, peptidomics classifier (PeptAKI) was reported predict better than biomarkers. Focusing [TIMP2]*[IGFBP7], cellular origin TIMP2 IGFBP7 remains unclear, especially under most common predisposing condition for i.e., chronic disease (CKD). We now discuss novel cell expression implications.