Evidence map›Paper›PMID 42552846›Full record

ReviewJournal of clinical laboratory analysis2026

The Landscape of Biomarkers in ICU-Associated AKI: From Protein Markers to Cell-Free Nucleic Acids.

Qi Zhu, Feng Yang, Hua Zheng, Xinxin Guo, Zhijin Chen, Limin Chen, Daoli Wang, Jiaqi Wang, Xinmeng Wang, Zhiyuan Huang and 1 more

Abstract readReview
In one paragraph

Review in Journal of clinical laboratory analysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Qi ZhuDepartment of Emergency, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Feng YangDepartment of Radiology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.ORCID https://orcid.org/0000-0002-9844-8182
Hua ZhengDepartment of Nephrology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Xinxin GuoDepartment of Nephrology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Zhijin ChenDepartment of Nephrology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Limin ChenDepartment of Nephrology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Daoli WangDepartment of Emergency, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Jiaqi WangDepartment of Emergency, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Xinmeng WangDepartment of Emergency, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Zhiyuan HuangDepartment of Emergency, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
Zhenhua JiDepartment of Nephrology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.ORCID https://orcid.org/0009-0006-8319-5369

Funding

Liaoning Provincial Natural Science Foundation of China 2024-BSLH-291
6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) affects approximately 30%-60% of intensive care unit (ICU) admissions, but early detection remains difficult because creatinine- and urine-output-based KDIGO criteria are delayed and confounded in critical illness.

objectiveTo summarize the biomarker landscape for ICU-associated AKI, focusing on kidney-targeted injury/stress proteins and circulating cell-free DNA (cfDNA), including mitochondrial DNA (mtDNA).

methodsPubMed/MEDLINE and Embase were searched from inception to December 31, 2025, using terms related to AKI, critical illness, NGAL, KIM-1, IL-18, L-FABP, [TIMP-2]·[IGFBP7], cfDNA, mtDNA, and damage-associated molecular patterns. Adult ICU studies reporting diagnostic performance, risk stratification, or clinically relevant outcomes were prioritized, especially in sepsis, cardiac surgery, shock, and trauma.

resultsNGAL, KIM-1, IL-18, L-FABP, and [TIMP-2]·[IGFBP7] often rise before creatinine or urine-output changes, providing early kidney-proximal signals of tubular injury or stress. cfDNA/mtDNA instead reflects systemic cell death, mitochondrial damage, and innate immune activation, capturing multi-organ injury and adding prognostic information beyond clinical scores and creatinine. Across ICU phenotypes, combining clinical risk, an early kidney-targeted marker, and cfDNA/mtDNA may improve identification of patients at risk for severe AKI, renal replacement therapy, and death.

conclusionsMultimarker strategies may widen the diagnostic window and sharpen prognostication in ICU-associated AKI. Routine implementation will require standardized pre-analytical handling, assay harmonization, biomarker-guided pragmatic trials, and trajectory-based decision tools that demonstrate clinical benefit.

Indexed as

Acute Kidney InjuryBiomarkersCell-Free Nucleic AcidsIntensive Care UnitsDNA, MitochondrialHepatitis A Virus Cellular Receptor 1HumansInterleukin-18Lipocalin-2BiomarkersCell-Free Nucleic AcidsDNA, MitochondrialHepatitis A Virus Cellular Receptor 1Interleukin-18Lipocalin-2AKIbiomarkerscfDNAICUmtDNAsepsis

Identifiers

PMID42552846
PMCPMC13439037

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.