A review on the role of urinary biomarkers in predicting renal recovery post-sepsis

Samar Abed Alharbi; Abdulrahman Hussain Alzahrani; Ahmed Saeed Alahmari; Saud Mohammed Ayyashi; Alaa Omar Aljeffry; Abdullah Hussain Alqarni; Lujain Salim Babkair; Mohammed Malek Alnasheet; Saad Mohammed Altarish; Meshari Nawaf Alharbi

doi:10.18203/2394-6040.ijcmph20244060

Authors

Samar Abed Alharbi Department of Internal Medicine, Al Thager Hospital, Jeddah, Saudi Arabia
Abdulrahman Hussain Alzahrani Department of Internal Medicine, Hera General Hospital, Mecca, Saudi Arabia
Ahmed Saeed Alahmari College of Medicine, University of Bisha, Bisha, Saudi Arabia
Saud Mohammed Ayyashi Department of Family Medicine, Khamis Mushait Primary Health Care, Abha, Saudi Arabia
Alaa Omar Aljeffry Department of Emergency Medicine, Hera General Hospital, Mecca, Saudi Arabia
Abdullah Hussain Alqarni Department of Emergency Medicine, Aseer Central Hospital, Almajardah, Saudi Arabia
Lujain Salim Babkair Department of Internal Medicine, Al Noor Specialist Hospital, Mecca, Saudi Arabia
Mohammed Malek Alnasheet Department of Emergency Medicine, Middle East Hospital, Manama, Bahrain
Saad Mohammed Altarish Aseer Central Hospital, Abha, Saudi Arabia
Meshari Nawaf Alharbi Department of Family Medicine, King Fahad Specialist Hospital, Buraydah, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20244060

Keywords:

Sepsis, AKI, Urinary biomarkers, NGAL, cfDNA, Renal recovery

Abstract

Acute kidney injury (AKI), which is commonly caused by sepsis and contributes significantly to worldwide mortality, may affect patient outcomes and increase the risk of chronic disease. This review examines how urinary biomarkers can forecast renal recovery following sepsis. Conventional AKI diagnostics, like serum creatinine, suffer from delayed detection and poor specificity. Newer urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL) and cell-free DNA (cfDNA), show potential for earlier detection and improved prognosis. NGAL, noted for its sensitivity to nephrotoxic and ischemic insults, shows potential in predicting AKI onset and recovery. Similarly, cfDNA levels, reflecting systemic cell death, correlate with sepsis severity and renal outcomes. Despite their promise, variability in biomarker levels due to comorbidities and the need for standardized diagnostic thresholds remain challenges. Combining multiple biomarkers may enhance diagnostic accuracy, offering a more comprehensive assessment of kidney function and sepsis-induced AKI (S-AKI). Further research is needed to validate these biomarkers and integrate them into clinical practice for improving patient outcomes post-sepsis.

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References

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