Methods and compositions for diagnosis and prognosis of renal injury and renal failure

A method for evaluating renal status in a subject for a predisposition of a future acute renal injury, comprising:

• obtaining a urine sample from the subject;
• performing one or more assays configured to detect by introducing the urine sample obtained from the subject into an assay instrument which contacts all or a portion of the urine sample with a binding reagent which specifically binds for detection cytochrome c, and (ii) generates an assay result indicative of binding of cytochrome c to the binding reagent;
• correlating the assay result generated by the assay instrument to the renal status of the subject, wherein said correlation step comprises correlating the assay result to one or more of risk stratification, staging, prognosis, classifying and monitoring of the renal status of the subject by using the one or more assay results to assign the patient to a predetermined subpopulation of individuals having a known predisposition of a future renal injury within 72 hours of the time at which the urine sample is obtained;
• and
• treating the patient based on the predetermined subpopulation of individuals to which the patient is assigned, wherein the treatment comprises one or more of initiating renal replacement therapy, withdrawing delivery of compounds that are known to be damaging to the kidney, delaying or avoiding procedures that are known to be damaging to the kidney, and modifying diuretic administration.