Biomarker-Based Diagnosis and Risk Stratification in Sepsis-Associated Acute Kidney Injury: From Molecular Mechanisms to Multimarker Panels

Sepsis-associated acute kidney injury (SA-AKI) remains a major diagnostic challenge in critically ill patients, as conventional functional criteria—serum creatinine and urine output—often detect AKI after clinically relevant pathophysiological derangement has already evolved. Increasing evidence suggests that SA-AKI reflects a heterogeneous process characterized by early cellular stress, microcirculatory dysfunction, inflammation-associated injury, and maladaptive repair preceding overt function