Introduction and Context
Acute kidney injury (AKI) is common in hospitalized patients and strongly linked to morbidity and mortality. Over the past two decades, a large and growing literature has evaluated biochemical biomarkers (for example, NGAL, KIM-1, TIMP‑2·IGFBP7) for early detection, differential diagnosis and prognosis of AKI. However, enthusiasm has been tempered by inconsistent results across studies and uncertainty about clinical utility. Many diagnostic test accuracy (DTA) studies differ in their patient selection, reference standards, timing of sampling, assay methods and reporting — factors that prevent meaningful synthesis of evidence and slow translation of promising biomarkers into practice.
Prompted by these gaps, an international expert panel convened to review the literature and propose extension items to the STARD (Standards for Reporting Diagnostic Accuracy) 2015 checklist specifically for AKI biomarker studies. The product — STARDaki — was published as a consensus extension in Intensive Care Medicine (Yu et al., 2026). It is intended to make studies more comparable, reproducible and clinically informative.
