Patients with acute kidney injury (AKI) continue to pose challenges for clinicians worldwide. Our understanding of the pathophysiology, epidemiology and course of the disease has improved significantly; however, this has not translated into any significant improvement in outcomes. Multiple new biomarkers have been developed to characterize the course of the disease and have been evaluated in multiple trials. Unfortunately, the adoption of biomarkers into routine clinical care has not been as expected. Several factors contribute to the slow uptake and can be addressed. This article provides a framework for a patient-centered approach to utilize biomarkers to improve patient care and outcomes in AKI.