Role of biomarkers in early detection of kidney injury and monitoring of therapy response in chidren

The diagnosis, classification and prognosis of early kidney injury by current clinical means are inadequate especially in the pediatric population as it relies on two functional abnormalities, changes in serum creatinine and oliguria which are late consequences of injury and not markers of the injury itself. We need simple, non-invasive, sensitive and specific biomarkers for early detection and monitoring of kidney injury in both acute and chronic disease setting as well as during renoprotective treatment. The aim of our study is: to document new urinary, plasma and tissue biomarkers that can be detected in acute and chronic kidney injury, to assess the diagnostic value of these biomarkers in early stage of the kidney injury, and to determine whether these biomarkers have prognostic value. The impact of five urine/plasma and/or renal tissue biomarkers [kidney injury molecule-1 (KIM-1), N-acetyl-Beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, and interleukin-18] will be estimated in experimental rat model of acute kidney injury, and in children with acute kidney injury or chronic glomerulopathy. We expect to establish an algorithm based on ‘biomarker panels’ for non-invasive assessment of early deterioration in kidney function and monitoring of therapy response with much higher accuracy than currently possible, and to improve pediatric RIFLE classification of acute kidney injury using new renal biomarkers.