{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:43:19Z","timestamp":1786653799791,"version":"build-2736575974"},"reference-count":59,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Current limitations exist in the availability of specific therapies for preventing acute kidney injury (AKI). Managing AKI poses challenges, particularly as interventions are often initiated only after a substantial increase in serum creatinine or a gradual decline in urine output. However, relying on these parameters raises concerns due to their insensitivity to acute changes. The timely detection of patients at risk of kidney disease through the diagnostic utility of biomarkers is essential for the prompt implementation of active interventions. Despite the initial optimism surrounding the discovery of AKI biomarkers, their integration into the routine care of at-risk patients lags behind and is underutilized, even after validations. Therefore, the utilization of biomarkers holds promise in promptly diagnosing AKI and improving patient outcomes. Despite notable technological advancements in various medical subspecialties, survival rates among acute and chronic kidney disease (CKD) patients have not witnessed significant improvement compared to other disciplines. While HIV infection and AIDS were once considered a death sentence, advancements in HIV treatment have allowed for control and longer-acting management. However, a definitive cure for CKD remains elusive. Nephrology research faces challenges, including the imperative to enhance both the quality and quantity of research. The number of randomized controlled trials in nephrology is notably lower compared to other subspecialties, with many yielding negative results. Studies evaluating hard clinical endpoints are also limited. This review provides an overview of recent advances in nephrology and the need for greater emphasis on incorporating hard clinical endpoints that could impact clinical practice.<\/jats:p>","DOI":"10.4103\/njcp.njcp_867_23","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:44:02Z","timestamp":1743295442000},"page":"137-144","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Recent Advances in Nephrology: The Research Gaps and the Need for Greater Emphasis on Incorporating Hard Clinical Endpoints"],"prefix":"10.4103","volume":"28","author":[{"given":"EN","family":"Okafor","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, College of Medicine, University of Nigeria, Enugu Campus, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SO","family":"Ebede","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EO","family":"Agbo","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Faculty of Basic Clinical Sciences, College of Medicine and Health Sciences, Baze University, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"R1-20260423","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1681\/ASN.2009060636","article-title":"Acute kidney injury associates with increased long-term mortality","volume":"21","author":"Lafrance","year":"2010","journal-title":"J Am Soc Nephrol"},{"key":"R2-20260423","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1038\/ki.2011.42","article-title":"The severity of acute kidney injury predicts progression to chronic kidney disease","volume":"79","author":"Chawla","year":"2011","journal-title":"Kidney Int"},{"key":"R3-20260423","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1038\/ki.2011.379","article-title":"Chronic kidney disease after acute kidney injury: A systematic review and meta-analysis","volume":"81","author":"Coca","year":"2012","journal-title":"Kidney Int"},{"key":"R4-20260423","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.amjmed.2012.01.016","article-title":"Risk of chronic dialysis and death following acute kidney injury","volume":"125","author":"Wald","year":"2012","journal-title":"Am J Med"},{"key":"R5-20260423","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1053\/j.ajkd.2017.08.027","article-title":"Acute kidney injury and risk of incident heart failure among US veterans","volume":"71","author":"Bansal","year":"2018","journal-title":"Am J Kidney Dis"},{"key":"R6-20260423","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1159\/000368902","article-title":"Association of de novo dipstick albuminuria with severe acute kidney injury in critically ill septic patients","volume":"128","author":"Neyra","year":"2014","journal-title":"Nephron Clin Pract"},{"key":"R7-20260423","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00134-015-3934-7","article-title":"Epidemiology of acute kidney injury in critically ill patients. 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