Acute kidney injury (AKI) is a severe and prevalent syndrome, primarily observed in intensive care units (ICUs) and perioperative settings. The discovery of a new biomarker for kidney function and injury, capable of overcoming the limitations of traditional markers, has the potential to improve the diagnosis and management of AKI. Proenkephalin A 119–159 (PENK) has emerged as a novel biomarker for AKI and has been validated in various clinical settings. It has demonstrated a faster response to AKI compared to creatinine and has been shown to predict successful weaning from renal replacement therapy in the ICU. PENK has also shown promise as an AKI biomarker in perioperative patients. Additionally, PENK has been proven to be effective in estimating mortality and morbidity in patients undergoing cardiac surgery, and those with traumatic brain injury or ischemic stroke. Incorporating PENK into a novel estimation of the glomerular filtration rate, referred to as the PENK-Crea equation, has yielded promising results.

Background: Acute kidney injury (AKI) remains one of the most common perioperative complications, carrying substantial mortality and healthcare burden. Traditional diagnostic criteria relying on serum creatinine and urine output are limited by delayed detection and inability to characterize the underlying injury phenotype. This scoping review examined the current state of novel AKI biomarker research in perioperative care, evaluated their clinical implementation, and identified knowledge gaps. Methods: A systematical search was performed for studies investigating novel AKI biomarkers in surgical settings. Biomarkers were categorized as functional, stress, or damage markers. Data extraction focused on diagnostic performance, clinical outcomes, regulatory approval status, and implementation barriers. A narrative synthesis was organized by biomarker category and thematic areas. Results: Several biomarkers demonstrated superior early diagnostic performance compared to traditional ones, including PENK or CCL-14, showing promising accuracy for AKI detection and outcome prediction. TIMP-2*IGFBP-7 and NGAL achieved regulatory approval, and biomarker-guided KDIGO care bundles significantly reduced AKI incidence in surgical populations. However, substantial heterogeneity exists in assays, cutoff values, and clinical validation across different clinical settings. Conclusions: Novel AKI biomarkers offer a promise for early detection and risk stratification in perioperative care, yet widespread clinical adoption requires addressing standardization challenges, establishing cost-effectiveness, and validating implementation strategies.

Kandydemia jest jedną z najczęstszych infekcji szpitalnych, przebiegających z wysoką śmiertelnością. Zakażenia związane z centralnymi cewnikami żylnymi o etiologii grzybiczej mogą być pochodzenia endogennego (większość zakażeń Candida spp.) lub egzogennego. W opisywanym przypadku 65-letni pacjent był przyjęty do Kliniki Chirurgii Ogólnej, Gastroenterologicznej i Onkologicznej z powodu powikłania choroby Leśniowskiego-Crohna – perforacji przewodu pokarmowego z kałowym zapaleniem otrzewnej.

Acute Kidney Injury (AKI) following endovascular aortic repair (EVAR) is often diagnosed too late using conventional markers, limiting opportunities for timely intervention in this high-risk population. We investigated whether a mechanism-based biomarker panel could provide improved early AKI detection in EVAR patients. This prospective, single-center study enrolled 68 consecutive EVAR patients between April 2022 and June 2024. AKI was diagnosed using KDIGO 2012 criteria. Seven novel biomarkers, including Proenkephalin A 119-159 (penKid), Semaphorin-3A (SEMA-3A), Retinol Binding Protein-4 (RBP-4), Kidney Injury Molecule-1 (KIM-1), Netrin-1, Tissue Inhibitor of Metalloproteinases-2, and Insulin-Like Growth Factor Binding Protein-7, were measured at baseline, immediate postoperative, 24 h, and 48 h time points, and selected based on distinct nephron locations and release mechanisms. AKI occurred in 18 (26.5%) patients. Top-performing individual biomarkers included serum SEMA-3A (AUC 0.88), serum RBP-4 (AUC 0.81), and penKid (AUC 0.76). A three-biomarker panel combining serum penKid, serum SEMA-3A, and urinary KIM-1 achieved robust discriminatory performance (AUC 0.89, 95% CI 0.77–1.00), superior to individual biomarkers. An alternative panel with serum RBP-4 demonstrated comparable performance (AUC 0.81, 95% CI 0.65–0.99). Multi-biomarker panels combining functional, stress, and injury markers demonstrate promising performance for early AKI detection in EVAR patients. External validation in independent, multi-center cohorts is required before clinical implementation.