Article ; Online: Definitions, phenotypes, and subphenotypes in acute kidney injury-Moving towards precision medicine.
2022 Volume 28, Issue 2, Page(s) 83–96
Abstract: The current definition of acute kidney injury (AKI) is generic and, based only on markers of function, is unsuitable for guiding individualized treatment. AKI is a complex syndrome with multiple presentations and causes. Targeted AKI management will only ...
Abstract | The current definition of acute kidney injury (AKI) is generic and, based only on markers of function, is unsuitable for guiding individualized treatment. AKI is a complex syndrome with multiple presentations and causes. Targeted AKI management will only be possible if different phenotypes and subphenotypes of AKI are recognised, based on causation and related pathophysiology. Molecular signatures to identify subphenotypes are being recognised, as specific biomarkers reveal activated pathways. Assessment of individual clinical risk needs wider dissemination to allow identification of patients at high risk of AKI. New and more timely markers for glomerular filtration rate (GFR) are available. However, AKI diagnosis and classification should not be limited to GFR, but include tubular function and damage. Combining damage and stress biomarkers with functional markers enhances risk prediction, and identifies a population enriched for clinical trials targeting AKI. We review novel developments and aim to encourage implementation of these new techniques into clinical practice as a strategy for individualizing AKI treatment akin to a precision medicine-based approach. |
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MeSH term(s) | Humans ; Precision Medicine/adverse effects ; Creatinine ; Phenotype ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Biomarkers |
Chemical Substances | Creatinine (AYI8EX34EU) ; Biomarkers |
Language | English |
Publishing date | 2022-11-25 |
Publishing country | Australia |
Document type | Journal Article ; Review |
ZDB-ID | 1303661-0 |
ISSN | 1440-1797 ; 1320-5358 |
ISSN (online) | 1440-1797 |
ISSN | 1320-5358 |
DOI | 10.1111/nep.14132 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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