Duff S, Irwin R, Cote JM, et al. - Stage 1-2 acute kidney injury (AKI) progression was shown to be best predicted by Cystatin C, IL-18, Albumin and NGAL among 14 novel urinary biomarkers evaluated in critically ill patients in this study. If further validated, these biomarkers may be useful in informing diagnostic and prognostic evaluation as well as in guiding management of AKI in critically ill patients.

• AKI occurs commonly in hospitalized patients and is related to high morbidity and mortality.

• This prospective cohort study, Dublin Acute Biomarker Group Evaluation (DAMAGE) Study, involved 717 critically ill patients.

• Eight of the 14 biomarkers were found to be independently linked with progression.

• Cystatin C, IL-18, Albumin and NGAL were revealed as best predictors, with aOR 5.2, 5.1, 4.9, 4.6, respectively.

• These biomarkers conferred improved prediction was also revealed in ROC and Net Reclassification Index analyses.

• Secondary (prognostic) analysis of Stage 1-3 AKI cases showed independent links of IL-18, NGAL, Albumin, and MCP-1 with RRT or Death within 30 days.