Biomarker enhanced management of acute kidney injury in Indian patients

Acute Kidney Injury (AKI) is a complex disorder encountered from 5% in hospitalized patients and 40-60% in ICU setting. it is associated with high mortality and increased resource utilization . Clinical trials have demonstrated the efficacy of these new biomarkers in detecting kidney damage, predicting disease progression and determining potential recovery. Two Randomized clinical trials have shown the efficacy of TIMP2 and IGFBP biomarkers in Cardiac surgery (PREVAKI)2 and high risk surgery patients (BIGPAK)3 to improve outcomes. Unfortunately the adoption of damage biomarkers into routine clinical care worldwide has been limited. In This study we propose to characterize the utility of nephrocheck in the diagnosis,  differentiation and management of AKI in patients with sepsis and major surgery in the ICU across multiple centers in india provide new information on patterns of AKI development, course and management and ascertain the barriers to boimarker applications in this setting.  The data obtained will inform the development of best practices for optimal utilization of the nephrocheck markers to improve outcomes from AKI.