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General Critical Care
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Biomarkers in pursuit of precision medicine for acute kidney injury: hard to get rid of customs (krcp-ksn.org)
Proposed strategies for managing AKI.
The definition of AKI encompasses an escalation in serum creatinine levels, a decrease in urine output, and the presence of kidney damage and stress biomarkers. Various biomarkers, some of which are accessible at the point of care, may assist in the early detection of AKI. These biomarkers can facilitate the timely identification of patients who exhibit potential endotypes, amenable traits for targeted interventions, or suitability for specific preventive measures. AKI subphenotypes, which are delineated by their clinical attributes, have already been integrated into routine clinical practice, including considerations such as etiology, AKI staging, severity, and duration. However, the integration of biomarkers into these subphenotypes may offer a more comprehensive and informative framework, culminating in predictive and prognostic insights. This refined definition of subphenotypes aims to distinguish patient subgroupsโฆ
Biomarkers for AKI subgroupingโdinosaur parkour illustration.
The clinical use of biomarkers in AKI is influenced by the heterogeneity of patient groups and outcomes. Biomarkers have a range of advantages, including the early detection of kidney injury, the identification of AKI subphenotypes (subsets of clinical features within a shared phenotype), the recognition of AKI endotypes (subsets of patients with distinct biological disease mechanisms), and the predictive enrichment of high-risk patient groups for specific care pathways or interventions.
AKI, acute kidney injury; CCL14, chemokine ligand 14; HJV, hemojuvelin; IL-18, interleukin-18; KIM-1, kidney injury molecule-1; NGAL, neutrophil gelatinase-associated lipocalin; PROENK, proenkephalin.
Biomarkers in pursuit of precision medicine for acute kidney injury: hard to get rid of customs (krcp-ksn.org)
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- Hussain Al-shabib
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Dilated RV with poor contraction and D shaped septum. Dilated RA.