Early Detection of Acute Kidney Injury: The Combined Role of Nursing Monitoring and Laboratory Biomarkers
DOI:
https://doi.org/10.22399/ijcesen.4341Keywords:
Acute kidney injury, early detection, nursing monitoring, laboratory biomarkers, serum creatinine, neutrophil gelatinase-associated lipocalinAbstract
Early detection of acute kidney injury (AKI) is crucial in minimizing potential complications and improving patient outcomes. The combined efforts of nursing monitoring and laboratory biomarkers play a pivotal role in this early identification process. Nurses are often the first line of observation in clinical settings, routinely assessing vital signs, urine output, and patient symptoms. Their ability to recognize subtle changes can provide critical insights that may indicate the onset of AKI. In parallel, advances in laboratory biomarkers, such as serum creatinine levels and novel urinary markers like neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1), enhance diagnostic accuracy. These biomarkers can detect kidney injury earlier than traditional methods, allowing for prompt intervention and treatment. The integration of nursing vigilance and laboratory biomarkers establishes a comprehensive approach to AKI management. Nurses equipped with knowledge of specific risk factors and signs of AKI can initiate further investigations rapidly, benefiting from the timely results of laboratory tests. This synergy enhances early diagnostic capabilities, enabling healthcare providers to implement targeted therapies sooner. Research has shown that a multidisciplinary approach involving nursing staff and laboratory technology not only facilitates early detection but also contributes to the overall quality of care, ultimately reducing hospital stays and improving patient safety. Thus, fostering a collaborative environment in which nursing monitoring and laboratory biomarker analysis coexist is essential in the fight against acute kidney injury.
References
1. Mårtensson J, Bellomo R. The rise and fall of NGAL in acute kidney injury. Blood Purif. 2014;37(4):304–10.
2. Kellum JA, Sileanu FE, Murugan R, Lucko N, Shaw AD, Clermont G. Classifying AKI by urine output versus serum creatinine level. J Am Soc Nephrol. 2015;26(9):2231–8.
3. Xie Y, Wang Q, Wang C, Qi C, Ni Z, Mou S. High urinary excretion of kidney injury molecule-1 predicts adverse outcomes in acute kidney injury: a case control study. Crit Care. 2016;20(1):286.
4. Bitker L, Patel SK, Bittar I, Eastwood GM, Bellomo R, Burrell LM. Reduced urinary levels of angiotensin-converting enzyme 2 activity predict acute kidney injury in critically ill patients. Crit Care Resusc. 2020;22(4):344–54.
5. Hull TD, Agarwal A, Hoyt K. New ultrasound techniques promise further advances in AKI and CKD. J Am Soc Nephrol. 2017;28(12):3452–60.
6. Zhen XW, Song NP, Ma LH, Ma LN, Guo L, Yang XD. Calprotectin and neutrophil Gelatinase-Associated Lipocalin as biomarkers of acute kidney injury in acute coronary syndrome. Am J Med Sci. 2021;361(6):736–43.
7. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179–84.
8. Lee HG, Choi HY, Bae JS. Endocan as a potential diagnostic or prognostic biomarker for chronic kidney disease. Kidney Int. 2014;86(6):1079–81.
9. Zhao W, Nikolic-Paterson DJ, Li K, Li Y, Wang Y, Chen X, et al. Selenium binding protein 1 protects renal tubular epithelial cells from ferroptosis by upregulating glutathione peroxidase 4. Chem Biol Interact. 2024;393:110944.
10. Sharan K, Sharma A, Rana S, Patnaik I, Gupta R. Neutrophil Gelatinase-associated Lipocalin predicts Short-term outcomes in decompensated cirrhosis with acute kidney injury. J Clin Exp Hepatol. 2024;14(1):101274.
11. Geng J, Qiu Y, Qin Z, Su B. The value of kidney injury molecule 1 in predicting acute kidney injury in adult patients: a systematic review and bayesian meta-analysis. J Transl Med. 2021;19(1):105.
12. Voth M, Verboket R, Henrich D, Marzi I. L-FABP and NGAL are novel biomarkers for detection of abdominal injury and hemorrhagic shock. Injury. 2023;54(5):1246–56.
13. Albert C, Zapf A, Haase M, Röver C, Pickering JW, Albert A, et al. Neutrophil Gelatinase-Associated Lipocalin measured on clinical laboratory platforms for the prediction of acute kidney injury and the associated need for Dialysis therapy: A systematic review and Meta-analysis. Am J Kidney Dis. 2020;76(6):826–e411.
14. Ueno A, Onishi Y, Mise K, Yamaguchi S, Kanno A, Nojima I et al. Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3). BMJ Open Diabetes Res Care. 2024;12(3).
15. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the acute disease quality initiative (ADQI) 16 workgroup. Nat Rev Nephrol. 2017;13(4):241–57.
16. Habeebullah, Aga S, Khatri S, Bajeer IA, Sultan S, Lanewala AA. Calculus anuria: a urological emergency with an excellent outcome. Urolithiasis. 2023;51(1):51.
17. Priyanka P, Zarbock A, Izawa J, Gleason TG, Renfurm RW, Kellum JA. The impact of acute kidney injury by serum creatinine or urine output criteria on major adverse kidney events in cardiac surgery patients. J Thorac Cardiovasc Surg. 2021;162(1):143–e517.
18. Pieters TT, van Dam MJ, Sikma MA, van Arkel A, Veldhuis WB, Verhaar MC, et al. Estimation of renal function immediately after cessation of continuous renal replacement therapy at the ICU. Sci Rep. 2024;14(1):21098.
19. Ostermann M, Bellomo R, Burdmann EA, Doi K, Endre ZH, Goldstein SL et al. Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference. Kidney Int. 2020;98(2):294–309.
20. Yanishi M, Kinoshita H. Urinary L-type fatty acid-binding protein is a predictor of cisplatin-induced acute kidney injury. BMC Nephrol. 2022;23(1):125.
21. Peabody J, Paculdo D, Valdenor C, McCullough PA, Noiri E, Sugaya T, et al. Clinical utility of a biomarker to detect Contrast-Induced acute kidney injury during percutaneous cardiovascular procedures. Cardiorenal Med. 2022;12(1):11–9.
22. Fang M, Li J, Fang H, Wu J, Wu Z, He L, et al. Prediction of acute kidney injury after total aortic arch replacement with serum Cystatin C and urine N-acetyl-β-d-glucosaminidase: A prospective observational study. Clin Chim Acta. 2023;539:105–13.
23. Levey AS, James MT. Acute kidney injury. Ann Intern Med. 2017;167(9):ITC65–.
24. Azimi A. Could calprotectin and endocan serve as troponin of nephrologists?? Med Hypotheses. 2017;99:29–34.
25. Westhoff JH, Seibert FS, Waldherr S, Bauer F, Tönshoff B, Fichtner A, et al. Urinary calprotectin, kidney injury molecule-1, and neutrophil gelatinase-associated Lipocalin for the prediction of adverse outcome in pediatric acute kidney injury. Eur J Pediatr. 2017;176(6):745–55.
26. Akin A, Demir AK, Özmen ZC. Serum and urinary angiotensinogen levels as prognostic indicators in acute kidney injury: a prospective study. Rev Assoc Med Bras (1992). 2023;69(12):e20230716.
27. Ronco C, Bellomo R, Kellum JA. Acute kidney injury. Lancet. 2019;394(10212):1949–64.
28. Vakili M, Fahimi D, Esfahani ST, Sharifzadeh M, Moghtaderi M. Comparative analysis between urinary calprotectin and serum creatinine for early detection of intrinsic acute kidney injury. Indian J Nephrol. 2021;31(4):353–7.
29. Califf RM. Biomarker definitions and their applications. Exp Biol Med (Maywood). 2018;243(3):213–21.
30. Kim KS, Yang HY, Song H, Kang YR, Kwon J, An J, et al. Identification of a sensitive urinary biomarker, selenium-binding protein 1, for early detection of acute kidney injury. J Toxicol Environ Health A. 2017;80(9):453–64.
31. Pickkers P, Darmon M, Hoste E, Joannidis M, Legrand M, Ostermann M, et al. Acute kidney injury in the critically ill: an updated review on pathophysiology and management. Intensive Care Med. 2021;47(8):835–50.
32. Heller F, Frischmann S, Grünbaum M, Zidek W, Westhoff TH. Urinary calprotectin and the distinction between prerenal and intrinsic acute kidney injury. Clin J Am Soc Nephrol. 2011;6(10):2347–55.
33. Ostermann M, Legrand M, Meersch M, Srisawat N, Zarbock A, Kellum JA. Biomarkers in acute kidney injury. Ann Intensive Care. 2024;14(1):145.
34. Wen Y, Parikh CR. Current concepts and advances in biomarkers of acute kidney injury. Crit Rev Clin Lab Sci. 2021;58(5):354–68.
35. Li Q, Huang Y, Shang W, Zhang Y, Liu Y, Xu G. The predictive value of urinary kidney injury molecular 1 for the diagnosis of Contrast-Induced acute kidney injury after cardiac catheterization: A Meta-Analysis. J Interv Cardiol. 2020;2020:4982987.
36. Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int. 2012;81(5):442–8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 International Journal of Computational and Experimental Science and Engineering
This work is licensed under a Creative Commons Attribution 4.0 International License.
