Pediatric Nephrology

, Volume 26, Issue 1, pp 29–40 | Cite as

Biomarkers of acute kidney injury in children: discovery, evaluation, and clinical application

  • Zubaida Al-Ismaili
  • Ana Palijan
  • Michael ZappitelliEmail author


Acute kidney injury (AKI) in children is associated with increased mortality and prolonged length of hospital stay and may also be associated with long-term chronic kidney disease development. Despite encouraging results on AKI treatment in animal studies, no specific treatment has yet been successful in humans. One of the important factors contributing to this problem is the lack of an early AKI diagnostic test. Serum creatinine, the current main diagnostic test for AKI, rises late in AKI pathophysiology and is an inaccurate marker of acute changes in glomerular filtration rate. Therefore, new biomarkers of AKI are needed. With great advancements in genomics, proteomics, and metabolomics, new AKI biomarkers, mainly consisting of urinary proteins that appear in response to renal tubular cell injury, have been, and continue to be, discovered. These new biomarkers offer promise for early AKI diagnosis and for the depiction of severity of renal injury occurring with AKI. This review provides a summary of what a biomarker is, why we need new biomarkers of AKI, and how biomarkers are discovered and should be evaluated. The review also provides a summary of selected AKI biomarkers that have been studied in children.


Acute renal failure Children Diagnostic test Chronic kidney disease Genomics Proteomics 



Dr. Zappitelli receives salary support from the Kidney Research Scientist Core Education and National Training Program and the Fondation de Recherche en Sante du Quebec.


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Copyright information

© IPNA 2010

Authors and Affiliations

  • Zubaida Al-Ismaili
    • 1
  • Ana Palijan
    • 1
  • Michael Zappitelli
    • 1
    Email author
  1. 1.Department of Pediatrics, Division of Nephrology, Montreal Children’s HospitalMcGill University Health CentreMontrealCanada

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