Devarajan Prasad
Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229-3039, USA.
Contrib Nephrol. 2007;156:203-12. doi: 10.1159/000102085.
Acute kidney injury (AKI) is a major clinical problem with a rising incidence and high mortality rate. The lack of early biomarkers has resulted in an unacceptable delay in initiating therapies.
Here we will update the reader on promising new blood and urinary biomarkers that have recently emerged through the application of innovative technologies such as functional genomics and proteomics to human and animal models of AKI.
The most promising biomarkers of AKI for clinical use include a plasma panel (NGAL and cystatin C) and a urine panel (NGAL, Il-18 and KIM-1).
As they represent tandem biomarkers, it is likely that the AKI panels will be useful for timing the initial insult and assessing the duration and severity of AKI. Based on the differential expression of the biomarkers, it is also likely that the AKI panels will distinguish between the various types and etiologies of AKI. It will be important in future studies to validate the sensitivity and specificity of these biomarker panels in clinical samples from large cohorts and from multiple clinical situations.
急性肾损伤（AKI）是一个主要的临床问题，其发病率不断上升且死亡率高。缺乏早期生物标志物导致启动治疗出现了不可接受的延迟。
在此，我们将向读者介绍通过将功能基因组学和蛋白质组学等创新技术应用于AKI的人类和动物模型而最近出现的有前景的新型血液和尿液生物标志物。
最有前景的用于临床的AKI生物标志物包括一个血浆组合（中性粒细胞明胶酶相关脂质运载蛋白[NGAL]和胱抑素C）和一个尿液组合（NGAL、白细胞介素-18和肾损伤分子-1[KIM-1]）。
由于它们代表串联生物标志物，AKI组合很可能有助于确定初始损伤的时间，并评估AKI的持续时间和严重程度。基于生物标志物的差异表达，AKI组合也很可能区分AKI的各种类型和病因。在未来的研究中，验证这些生物标志物组合在来自大型队列和多种临床情况的临床样本中的敏感性和特异性将很重要。
