Contrast-induced
acute kidney injury (CI-AKI) is a problem associated with the use of iodinated
contrast media, causing kidney dysfunction in patients with preexisting
renal failure. It accounts for 12% of all hospital-acquired
kidney failure and increases the length of hospitalization, a situation that is worsening with increasing numbers of patients with comorbidities, including those requiring cardiovascular interventional procedures. So far, its diagnosis has relied upon the rise in
creatinine levels, which is a late marker of kidney damage and is believed to be inadequate. Therefore, there is an urgent need for
biomarkers that can detect CI-AKI sooner and more reliably. In recent years, many new
biomarkers have been characterized for AKI, and these are discussed particularly with their use in known CI-AKI models and studies and include
neutrophil gelatinase-associated lipocalin,
cystatin C (Cys-C), kidney injury molecule-1,
interleukin-18, N-acetyl-β-d-
glucosaminidase, and L-type
fatty acid-binding protein (L-FABP). The potential of
miRNA and metabolomic technology is also mentioned. Early detection of CI-AKI may lead to early intervention and therefore improve patient outcome, and in future any one or a combination of several of these markers together with development in technology for their analysis may prove effective in this respect.