Sodhi K, Chanchalani G, Tyagi N. Current role of biomarkers in the initiation and weaning of kidney replacement therapy in acute kidney injury. World J Nephrol 2025; 14(1): 99802 [DOI: 10.5527/wjn.v14.i1.99802]
Corresponding Author of This Article
Kanwalpreet Sodhi, DA, DNB, MBBS, Doctor, Department of Critical Care, Deep Hospital, Model Town, Ludhiana 141002, Punjab, India. drkanwal2006@yahoo.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kanwalpreet Sodhi, Department of Critical Care, Deep Hospital, Ludhiana 141002, Punjab, India
Gunjan Chanchalani, Department of Critical Care Medicine, Karamshibhai Jethabhai Somaiya Hospital and Research Centre, Mumbai 400022, India
Niraj Tyagi, Department of Critical Care Medicine, Sir Ganga Ram Hospital, New Delhi 110060, Delhi, India
Co-corresponding authors: Kanwalpreet Sodhi and Gunjan Chanchalani.
Author contributions: Sodhi K and Chanchalani G made the detailed tables encompassing the studies on biomarkers; Sodhi K and Tyagi N conceptualized the topic for discussion; Sodhi K, Chanchalani G and Tyagi N helped in literature search and writing the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kanwalpreet Sodhi, DA, DNB, MBBS, Doctor, Department of Critical Care, Deep Hospital, Model Town, Ludhiana 141002, Punjab, India. drkanwal2006@yahoo.com
Received: July 30, 2024 Revised: October 16, 2024 Accepted: November 12, 2024 Published online: March 25, 2025 Processing time: 173 Days and 15.3 Hours
Abstract
The occurrence of acute kidney injury (AKI) in critically ill patients is often associated with increased morbidity and mortality rates. Despite extensive research, a consensus is yet to be arrived, especially regarding the optimal timing and indications for initiation of kidney replacement therapy (KRT) for critically ill patients. There is no clear guidance available on the timing of weaning from KRT. More recently, various biomarkers have produced promising prognostic prediction in such patients, regarding the need for KRT and its termination. Most of these biomarkers are indicative of kidney damage and stress, rather than recovery. However, large-scale validation studies are required to guide the cutoff values of these biomarkers among different patient cohorts so as to identify the optimum timing for KRT. This article reviews the kidney biomarkers in detail and summarizes the individual roles of biomarkers in the decision-making process for initiation and termination of the KRT among critically ill AKI patients and the supportive literature.
Core Tip: Routinely, > 50% of patients with acute kidney injury in intensive care require kidney replacement therapy (KRT). However, there are no clearcut guiding parameters on timing of initiation or weaning from KRT. Biomarkers have a promising role in initiation of KRT and can be used in decision-making for weaning from KRT. In this narrative review we summarize the individual roles of biomarkers and the supportive literature.
