Urinary biomarkers in acute kidney transplant dysfunction

Background: Acute kidney injury (AKI) is a common medical problem among kidney transplant recipients, which may cause a significant impact on patient and allograft survival. Currently, an allograft biopsy remains the 'gold standard' for assessing the cause of impaired kidney function. Limitations of the allograft biopsy include the risk of bleeding, injury to the adjacent viscera, and the possibility of sampling error leading to an inadequate diagnosis. Methods: We conducted a comprehensive review of the literature and main published data that discussed the most relevant biomarkers in acute allograft dysfunction, along with their clinical significance. Results: There have been significant discoveries of several important biomarkers that correlated with biopsy findings, clinical outcomes and possibly graft survival. Conclusion: The discovery of surrogate biomarkers in kidney transplantation is an evolving field of crucial importance that mandates further collaborative efforts.