[Acute renal failure--the present and perspectives].

Acute kidney injury is a common complication in hospitalized patients, and its incidence has risen significantly in the past 15 yr. Despite significant technical advances in therapeutics, the mortality and morbidity rates associated with acute kidney injury remain dismally high and have not appreciably improved during the past four decades. An ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury, acute tubular necrosis, early and accurately and may aid to risk stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay, and mortality. The major types of urinary biomarkers fall into three classes: 1) inflammatory; 2) renal tubular proteins that are excreted into the urine after injury; 3) surrogate markers of tubular injury. There has been increasing interest in the identification and validation of novel biomarkers of acute kidney injury that permit earlier and more accurate diagnosis.