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

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

• obtaining a urine sample from the adult subject;
• performing one or more assays configured to detect by introducing the urine sample obtained from the adult subject into an assay instrument which contacts all or a portion of the urine sample with a binding reagent which specifically binds for detection insulin-like growth factor IA (IGF-IA)(SEQ ID No. 2), and (ii) generates an assay result indicative of binding of insulin-like growth factor IA to the binding reagent;
• correlating the assay result generated by the assay instrument to the renal status of the adult 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 adult subject 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 adult subject based on the predetermined subpopulation of individuals to which the adult subject 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.