Rosner Mitchell H
Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Adv Clin Chem. 2009;49:73-97. doi: 10.1016/s0065-2423(09)49004-8.
Despite the well-known limitations, currently the most widely used biomarkers for the early detection of chronic kidney disease or acute kidney injury are proteinuria, serum creatinine, and blood urea nitrogen. All of these are less than optimal and tend to focus attention on later stages of injury when therapies may be less effective. Recently, there has been a great surge of interest in identifying novel biomarkers that can be easily detected in the urine that can diagnose renal injury at the earliest stages. A variety of methods have been employed to identify these biomarkers including transcriptomics, proteomics, metabolomics, lipidomics, and gene arrays. Currently, several candidate biomarkers have been identified and studied in different renal injury states. These include kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-18, and fatty-acid binding proteins (FABPs). This review will highlight the current state of knowledge of these biomarkers as well as the limitation of these biomarkers in the early diagnosis of renal injury.
尽管存在众所周知的局限性，但目前用于慢性肾脏病或急性肾损伤早期检测的最广泛使用的生物标志物是蛋白尿、血清肌酐和血尿素氮。所有这些都不尽人意，并且往往将注意力集中在损伤的后期阶段，而此时治疗可能效果较差。最近，人们对鉴定能够在尿液中轻松检测到的新型生物标志物产生了极大兴趣，这些生物标志物可以在最早阶段诊断肾损伤。已经采用了多种方法来鉴定这些生物标志物，包括转录组学、蛋白质组学、代谢组学、脂质组学和基因阵列。目前，已经在不同的肾损伤状态下鉴定并研究了几种候选生物标志物。这些包括肾损伤分子-1（KIM-1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、白细胞介素（IL）-18和脂肪酸结合蛋白（FABP）。本综述将重点介绍这些生物标志物的当前知识状态以及这些生物标志物在肾损伤早期诊断中的局限性。
