Biomarqueurs et insuffisance rénale aiguë

Acute renal failure is a common feature; acute kidney injury (AKI) is defined by an increase of more than 50% of the basal plasmatic creatinin concentration or by a decrease in urinary output below 0.5 mg/kg per hour during more than 6 hours. None of these parameters is a reliable AKI marker. Six biomarkers are under research and development programs to allow an early diagnosis of renal failure: cystatin C, interleukine 18 (IL-18), N-acetyl-beta-D-glucosaminidase (NAG) and liver-type fatty acid binding proteins (L-FABP) or the diagnosis of the mechanism: Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Kidney Injury Molecule 1 (KIM-1). Many clinical trials evaluating the performance of these biomarkers are performed after cardiac surgery under extracorporeal circulation. Acute renal failure increases plasma concentrations of brain natriuretic peptide (BNP) and troponin T but not troponin I.