Sensibilidad y especificidad de los biomarcadores en injuria renal aguda y enfermedad renal crónica: revisión sistemática

Abstract

Background: Acute kidney injury and chronic kidney disease represent public health problems with high morbidity and mortality. Early detection is essential to initiate timely treatment and to prevent complications. Traditional biomarkers currently in use show low sensitivity and specificity in early stages. In this context, new biomarkers with diagnostic potential have emerged. Objective: To evaluate the usefulness of neutrophil gelatinase–associated lipocalin, kidney injury molecule-1, interleukin-18, and cystatin C as diagnostic tools for acute kidney injury and chronic kidney disease, compared to serum creatinine, through a systematic review. Methods: A descriptive review was conducted on studies published between 2021 and 2025 in databases such as PubMed, Scopus, ScienceDirect, and SciELO. The search included MeSH descriptors and Boolean operators. The process followed the PRISMA 2020 guidelines. Results: Lipocalin and cystatin C showed higher sensitivity for detecting early acute kidney injury compared to creatinine. Cystatin C also demonstrated higher specificity in early chronic kidney disease. Kidney injury molecule-1 showed more utility in assessing tubular damage and severity in critically ill patients. Interleukin-18 proved to be a valuable prognostic biomarker in septic conditions. Overall, the four biomarkers had a higher negative predictive value than creatinine, favoring the exclusion of acute kidney injury in at-risk patients. Conclusions: The biomarkers analyzed represent emerging, complementary tools for early detection and risk stratification, with greater potential than serum creatinine in specific clinical settings. Keywords: acute kidney injury, chronic kidney disease, biomarkers, creatinine