Elucidation of the lung and kidney cross-talk in acute kidney injury(AKI) and evaluation of urinary midkine as a diagnostic marker of AKI.

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We have retrospectively studied a cohort of 2579 patients admitted to the intensive care unit. The total AKI prevalence was 30% according to the AKIN criteria and after adjustment for covariates, AKIN stages remained independently associated with in-hospital mortality. An observational, retrospective analysis has been performed for 52 ALI/ARDS patients controlled by the noninvasive positive pressure ventilation (NPPV). Various cytokine levels were elevated in bronchoalveolar lavage from ALI/ARDS patients who developed AKI. These biomarkers were sensitive predictor of the NPPV failures. These findings strongly suggested the organ cross-talk between kidney and lung in ALI/ARDS. Finally we have confirmed the potential of urinary midkine as a novel biomarker for the early detection of AKI.