NDT Advance Access originally published online on September 7, 2009
Nephrology Dialysis Transplantation 2009 24(11):3263-3265; doi:10.1093/ndt/gfp428
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© The Author 2009. Published by Oxford University Press [on behalf of ERA-EDTA]. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Creatinine as the gold standard for kidney injury biomarker studies?
1 Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School 2 Department of Biostatistics, Harvard School of Public Health 3 Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
Correspondence and offprint requests to: Sushrut S. Waikar; E-mail: swaikar@partners.org
Keywords: acute renal failure; biomarkers; creatinine
| The first 150 words of the full text of this article appear below. |
Before 2005, when the Acute Dialysis Quality Initiative proposed a consensus definition [1], acute kidney injury (formerly known as ‘acute renal failure’) was identified by most clinicians in the way that Justice Potter Stewart identified obscenity: they knew it when they saw it. Epidemiologists and clinical researchers, who needed an objective criterion, seemed to devise a different definition for every new study; indeed, over 35 definitions have been used to define AKI in the nephrology literature [2]. For Homer Smith, who introduced the term ‘acute renal failure’ in his textbook, The Kidney: Structure and Function in Disease and Health [3], a specific definition did not seem to matter: nowhere in his textbook does he propose a way to define AKI.
We know that definitions do matter in modern clinical medicine. The consensus definition of acute myocardial infarction, which has evolved over the years and