Limitations of Conventional Parameters and Role of Urinary Protein Biomarkers in the Determination of Drug Induced Acute Kidney Injury in Very Early Stage
R. Shanmuga Sundaram *
Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam- 638183, Tamilnadu, India.
B. R. Abhirama
Department of Pharmacy Practice, Shree Vidyadhiraja College of Pharmacy, Thiruvananthapuram, Kerala, India.
L. Gowtham
Department of Pharmacology, Madras Medical College, Chennai, Tamilnadu, India.
Gladys Kalpana
Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam- 638183, Tamilnadu, India.
M. Sudha
Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam- 638183, Tamilnadu, India.
T. Thiyagarajan
Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam- 638183, Tamilnadu, India.
S. Pushpa
Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam- 638183, Tamilnadu, India.
G. K. Priyadharsini
Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam- 638183, Tamilnadu, India.
*Author to whom correspondence should be addressed.
Abstract
Drug-induced Acute Kidney Injury (AKI) constitutes an important cause of acute renal failure and chronic kidney disease in present day clinical practice. Drug-induced acute renal failure (ARF) accounted for 20% of all ARF in an Indian study. The incidence and prevalence of chronic kidney disease (CKD) has dramatically increasing worldwide. Progression of AKI from mild or moderate to end stage may be prevented by selecting potentially effective therapies, if it is detected in very early stage. But early detection of AKI is often difficult due to paucity of early predictive noninvasive biomarkers. Development of omics technology has led to the identification of several urinary protein biomarkers and transcriptional biomarkers, which enable earlier detection of kidney injury. Urinary protein biomarkers have great benefit due to the easy or non-invasive availability of urine and many showing good predictive power. Several urinary protein biomarkers have been identified and have demonstrated superiority in detecting kidney injury in comparison to conventional parameters like serum creatinine (SCr), blood urea nitrogen (BUN) etc. These promising experimental biomarker of kidney damage require further confirmation of its use in routine clinical use.
Keywords: Kidney injury biomarkers, acute renal failure, SCr, BUN, omics