Abstract: A method for the early identification and prediction of elevated blood creatinine levels resulting from a reduction in kidney function in a subject, comprises contacting a urine sample from the subject with a capture molecule for a biomarker specific for the distal region of the renal tubule and which biomarker is released from said region when there is damage to said region indicative and predictive of elevated blood creatinine levels resulting from a reduction in kidney function. The method can be used to detect Acute Kidney Injury (AKI) caused by many conditions or diseases or through the administration of drugs. The method can indicate and/or predict a reduction in kidney function significantly earlier than the current standard creatinine test. Methods for predicting a need for renal replacement therapy (RRT) are also disclosed.

Abstract: A method for the early identification and prediction of an abrupt reduction in kidney function in a patient undergoing cardiothoracic (CT) surgery, including Cardio-Pulmonary Bypass (CPB), comprises contacting a urine sample from the patient with a capture molecule for a biomarker, especially ?GST, specific for the distal region of the renal tubule and which biomarker is released from said region when there is damage to said region indicative and predictive of an abrupt reduction in kidney function, the biomarker being detectable as early as intraoperatively or in the recovery stage post CT surgery, for example prior to transfer of the patient to the Intensive Care Unit (ICU), allowing for immediate corrective medical intervention. The method can be used to detect Acute Kidney Injury (AKI) and a requirement for Renal Replacement Therapy (RRT) namely dialysis, earlier than two hours post CT surgery and as early as zero hours post or during CT surgery or CPB.