MCAT and acute kidney injury: However these are neither very reliable nor sensitive biomarkers for renal function since their levels are influenced by multiple factors such as muscle mass, muscle injury, fluid therapy, and GFR (23).Using quantitative proteomics approaches combined with ELISA based validation, our study demonstrated that the metallothionein (MT) family of proteins are highly upregulated in day-of-admission plasma samples of ACLF patients at risk of developing AKI, prior to clinical onset of AKI.