Acute kidney injury in patients with prosthetic valve IE

Infective endocarditis (IE) is a serious disease with a high associated mortality rate, particularly when complicated by acute renal failure (ARF).In some cases, IE induces rapidly progressive glomerulonephritis and results in end-stage renal failure, which is associated with poor patient prognosis [1]. Patients with IE associated with ARF can be successfully treated with the proper use of antibiotics, surgery, renal replacement and ACEI/ARB therapies.Early detection of patients with impaired renal function may help to ensure more aggresive treatment and to improve clinical outcome. Serum creatinine is still gold standard of kidney injury, although it is well known as an insensitive and unreliable biomarker (for example, its concentration does not increase significantly until about half of the kidney function is lost). Considering these data, researches and clinicians are making great efforts in the past decade in order to discover and validate novel AKI biomarkers. Kidney injury molecule-1 (KIM-1), Neutrophil gelatinase-associated lipocalin (NGAL), Interleukin-18 (IL-18), Cystatin C (Cys-C) are some of new, promising markers of kidney damage which are currently in the focus ofpreclinical and clinical studies. Recent data suggest that some of these new biomarkers represent important parametars of acute tubular necrosis (ATN) and reliable predictors of development and prognosis of AKI. Beside that, monitoring of these markers could have significant importance for early di