---
title: "Biomarker Use for Acute Kidney Injury in Critically Ill Patients: Systematic Evidence Map and Prac"
id: "pubmed-42725835"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42725835"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42725835/"
doi: "10.1097/CCM.0000000000007362"
published_at: "2026-09-11T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Biomarker Use for Acute Kidney Injury in Critically Ill Patients: Systematic Evidence Map and Prac
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42725835
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42725835/)
- **DOI:** [10.1097/CCM.0000000000007362](https://doi.org/10.1097%2FCCM.0000000000007362)
- **Published At:** 2026-09-11T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This mapping review screened **6,805** records and included **1,116** clinical studies of novel kidney **biomarkers** in critically ill patients, using PubMed/MEDLINE and Embase as data sources. - The review aimed to create systematic evidence maps to guide implementation of biomarkers for **acute kidney injury (AKI)** in practice. - Adult populations made up **78.6%** of included studies; **93.3%** used a cohort design. - The most frequently studied clinical contexts were mixed critically ill cohorts, cardiac surgery, and sepsis, representing **69.5%** of studies. - Evidence maps were produced for studies that: predict AKI (**n = 944**), prognosticate clinical outcomes (**n = 647**), diagnose AKI etiology (**n = 109**), enrich clinical trials (**n = 6**), and manage AKI (**n = 12**). - Implementation use cases highlighted by the authors include surveillance of patients at risk for AKI, especially perioperative patients and those exposed to multiple nephrotoxins. - The authors conclude there is substantial evidence on biomarker diagnostic accuracy versus AKI diagnosis, but relatively few practical or interventional trials demonstrating clinical utility. - The review identifies gaps and priorities: move from predictive accuracy to management and enrichment trials to support clinical decision-making and implementation in critical care settings. - Keywords emphasized: **acute kidney injury**, **biomarkers**, **critical illness**, prediction, prognosis, and intensive care unit contexts.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Landscape of Biomarker Use in Critically Ill Patients: Systematic Evidence Map of Acute Kidney Injury and Implications for Practice [Sandra L Kane-Gill](https://pubmed.ncbi.nlm.nih.gov/?term=Kane-Gill+SL&cauthor_id=42725835)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-1 "Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA."), [Kevin M Boyer](https://pubmed.ncbi.nlm.nih.gov/?term=Boyer+KM&cauthor_id=42725835)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-2 "Society of Critical Care Medicine, Mt. Prospect, IL."), [Ayse Akcan Arikan](https://pubmed.ncbi.nlm.nih.gov/?term=Akcan+Arikan+A&cauthor_id=42725835)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-3 "Divisions of Critical Care Medicine and Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX."), [Erin F Barreto](https://pubmed.ncbi.nlm.nih.gov/?term=Barreto+EF&cauthor_id=42725835)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-4 "Department of Pharmacy, Mayo Clinic, Rochester, MN."), [Justin M Belcher](https://pubmed.ncbi.nlm.nih.gov/?term=Belcher+JM&cauthor_id=42725835)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-5 "Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT."), [Nuttha Lumlertgul](https://pubmed.ncbi.nlm.nih.gov/?term=Lumlertgul+N&cauthor_id=42725835)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-6 "Centre of Excellence in Critical Care Nephrology and Excellence Centre in Critical Care Nephrology, Division of Nephrology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand."), [John A Kellum](https://pubmed.ncbi.nlm.nih.gov/?term=Kellum+JA&cauthor_id=42725835)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#full-view-affiliation-7 "The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.") Affiliations Expand ### Affiliations * 1 Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA. * 2 Society of Critical Care Medicine, Mt. Prospect, IL. * 3 Divisions of Critical Care Medicine and Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX. * 4 Department of Pharmacy, Mayo Clinic, Rochester, MN. * 5 Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. * 6 Centre of Excellence in Critical Care Nephrology and Excellence Centre in Critical Care Nephrology, Division of Nephrology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand. * 7 The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. * PMID: **42725835** * DOI: [ 10.1097/CCM.0000000000007362 ](https://doi.org/10.1097/ccm.0000000000007362) Item in Clipboard # Landscape of Biomarker Use in Critically Ill Patients: Systematic Evidence Map of Acute Kidney Injury and Implications for Practice Sandra L Kane-Gill et al. Crit Care Med. 2026. Show details Display options Display options Format Abstract PubMed PMID Crit Care Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Crit+Care+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Crit+Care+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42725835/) . 2026 Sep 11. doi: 10.1097/CCM.0000000000007362. Online ahead of print. ### Authors [Sandra L Kane-Gill](https://pubmed.ncbi.nlm.nih.gov/?term=Kane-Gill+SL&cauthor_id=42725835)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-1 "Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA."), [Kevin M Boyer](https://pubmed.ncbi.nlm.nih.gov/?term=Boyer+KM&cauthor_id=42725835)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-2 "Society of Critical Care Medicine, Mt. Prospect, IL."), [Ayse Akcan Arikan](https://pubmed.ncbi.nlm.nih.gov/?term=Akcan+Arikan+A&cauthor_id=42725835)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-3 "Divisions of Critical Care Medicine and Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX."), [Erin F Barreto](https://pubmed.ncbi.nlm.nih.gov/?term=Barreto+EF&cauthor_id=42725835)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-4 "Department of Pharmacy, Mayo Clinic, Rochester, MN."), [Justin M Belcher](https://pubmed.ncbi.nlm.nih.gov/?term=Belcher+JM&cauthor_id=42725835)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-5 "Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT."), [Nuttha Lumlertgul](https://pubmed.ncbi.nlm.nih.gov/?term=Lumlertgul+N&cauthor_id=42725835)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-6 "Centre of Excellence in Critical Care Nephrology and Excellence Centre in Critical Care Nephrology, Division of Nephrology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand."), [John A Kellum](https://pubmed.ncbi.nlm.nih.gov/?term=Kellum+JA&cauthor_id=42725835)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42725835/#short-view-affiliation-7 "The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.") ### Affiliations * 1 Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA. * 2 Society of Critical Care Medicine, Mt. Prospect, IL. * 3 Divisions of Critical Care Medicine and Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX. * 4 Department of Pharmacy, Mayo Clinic, Rochester, MN. * 5 Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. * 6 Centre of Excellence in Critical Care Nephrology and Excellence Centre in Critical Care Nephrology, Division of Nephrology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand. * 7 The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. * PMID: **42725835** * DOI: [ 10.1097/CCM.0000000000007362 ](https://doi.org/10.1097/ccm.0000000000007362) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objectives:** Create systematic evidence maps of novel biomarkers of kidney injury from a mapping review to guide future implementation in patient care. **Data sources:** PubMed/MEDLINE and Embase. **Study selection:** Systematic evidence maps included clinical trials and observational studies in critically ill patients, investigating novel kidney biomarkers for acute kidney injury (AKI). **Data extraction:** Six thousand eight hundred five records were screened, and 1116 studies were included that related to one or more novel biomarkers and AKI. **Data synthesis:** Adult populations accounted for 78.6% of the studies, and 93.3% used a cohort design to investigate AKI biomarkers. Mixed critically ill populations, cardiac surgery, and sepsis were identified as the most frequently studied clinical contexts in 69.5% of the studies. Systematic evidence maps were synthesized for biomarker studies to predict AKI (n = 944), prognosticate clinical outcomes (n = 647), diagnose AKI etiology (n = 109), enrich clinical trials (n = 6), and manage AKI (n = 12). Implementation strategies for patient care included surveilling patients at risk of AKI, including patients undergoing surgery and those exposed to multiple nephrotoxic drugs. **Conclusions:** Substantial clinical evidence assessing the accuracy of biomarkers compared with diagnosis of AKI exists, with fewer practical trials in clinical use. Still, guidance on implementation approaches can be gleaned from evaluations using biomarkers for the management of critically ill patients, particularly in surgical and nephrotoxin-exposed populations where evidence is available. This review identifies the landscape of current evidence and highlights priorities for future management and enrichment trials needed to bridge the gap between predictive accuracy and clinical decision-making. **Keywords:** acute kidney injury; biomarkers; critical illness; intensive care unit; prediction; prognosis. Copyright © 2026 by the Society of Critical Care Medicine and Wolters Kluwer Health, LLC. All Rights Reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Dr. Kane-Gill served as an advisor for the American Board of Internal Medicine and received research support from the National Center for Complementary and Integrative Health and the National Institute of Diabetes and Digestive and Kidney Diseases; she also served as a consultant for Perplexity AI. Dr. Akcan Arikan served as an advisor for SeaStar Medical, CSL Vifor, and Mallinckrodt and received research support from Mozarc. Dr. Barreto served as an advisor for Baxter and as a consultant for Wolters Kluwer. Dr. Kellum received funding from AstraZeneca, Bayer, Chugai Pharma, Mitsubishi Tanabe, bioMérieux, Novartis, and Spectral Medical; he disclosed that he is Chief Executive Officer of Spectral Medical; and he disclosed that he is inventor of several patents held by the University of Pittsburgh. The remaining authors have disclosed that they do not have any potential conflicts of interest. ## References 1. 1. Campbell F, Tricco AC, Munn Z, et al.: Mapping reviews, scoping reviews, and evidence and gap maps (EGMs): The same but different—the “Big Picture” review family. Syst Rev 2023; 12:45 2. 1. Miake-Lye IM, Hempel S, Shanman R, et al.: What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev 2016; 5:28 3. 1. Veritas Health Innovation: Covidence Systematic Review Software. Available at: [www.covidence.org](http://www.covidence.org). Accessed May 13, 2024 4. 1. FDA-NIH Biomarker Working Group: BEST (Biomarkers, EndpointS, and other Tools) Resource. Food and Drug Administration (US)/National Institutes of Health (US), 2016 5. 1. Bellomo R, Ronco C, Kellum JA, et al.; Acute Dialysis Quality Initiative workgroup: Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. 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