The role of the clinical laboratory in the detection and monitoring of acute kidney injury

Acute kidney injury (AKI) is a common syndrome presenting in multiple clinical settings and is frequently associated with serious short and long term adverse outcomes, which not only have impact on the patient but also on the health service increasing hospitalisation time and the costs related to the treatment. Early diagnosis and identification of the aetiology are essential for the management of the patients. During the last ten years, significant advances have been made towards the definition of this syndrome. The current consensus definitions of AKI include both changes in serum creatinine concentration and urine output. Although proposal have been made for the inclusion of novel biomarkers in the diagnostic workup of AKI as independent diagnostic markers these are not currently included in these definitions. In this review we will focus on these definitions and we will try to highlight their strengths and limitations in diagnosis and staging of AKI. Moreover, we will try to highlight the contribution of the clinical laboratory in AKI diagnosis in both the clinical and research settings.