Acute Kidney Injury in Urgent Surgical Pathology: The Diagnostic Role of Biomarkers

The aim of this scientific review was to analyze current concepts of acute kidney injury (AKI) in urgent surgical pathology and the role of neutrophil gelatinase-associated lipocalin (NGAL), uromodulin, and cystatin C in early preclinical diagnostics of this complication. A literature search was conducted on the electronic databases Pubmed, e-library, Cyberleninka, and Google Scholar Search. Biochemical and pathophysiological processes occurring in the body during AKI are considered. In surgical pathology, the main pathophysiological mechanism of AKI is systemic vasodilation accompanying systemic inflammatory response syndrome. In this regard, the greatest attention of researchers was attracted by the biomarkers NGAL, cystatin C, and uromodulin. According to the literature, NGAL allows to identify nephrotoxicity at an earlier stage, which is important for making timely clinical decisions and adequate correction of therapy. High lipocalin levels may serve as a potential biomarker not only for diagnosis but also for predicting clinical outcomes in patients with acute surgical pathology. Preoperative uromodulin levels, despite baseline renal function, may be an important risk factor for the development of AKI. The use of the biomarkers discussed in this article will allow practicing surgeons to diagnose AKI at the preclinical stage and, in some cases, prevent the development of this condition.