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急性护理环境中用于肾损伤的生物标志物的应用进展。

Evolving use of biomarkers for kidney injury in acute care settings.

机构信息

Division of Cardiology, Department of Medicine, San Diego Veterans Affairs Medical Center and University of California San Diego, CA 92161, USA.

出版信息

Curr Opin Crit Care. 2010 Oct;16(5):399-407. doi: 10.1097/MCC.0b013e32833e10bc.

Abstract

PURPOSE OF REVIEW

Acute kidney injury is increasingly recognized in acute care settings in more recent years. Proper diagnosis and risk stratification for acute kidney injury is necessary for carrying out appropriate and cost-effective treatments in patients with acute kidney injury. Kidney markers serve as diagnostic and prognostic tools to give physicians a more complete perspective of renal insult. The aim of this review is to highlight some of the evidence from recent studies, involving kidney markers and provide current opinion on the accuracy of these markers.

RECENT FINDINGS

Recent studies demonstrate that novel kidney markers such as cystatin C, interleukin-18, kidney injury molecule 1, and neutrophil gelatinase-associated lipocalin serve as more accurate markers for acute kidney injury as compared with the more traditional marker, creatinine. Additionally, there seems to be a correlation between the concentrations of each marker and the level of deterioration of kidneys, patient recovery time, length of hospital stay, and hospital costs.

SUMMARY

Each individual kidney marker possesses its own strengths and weaknesses in determining the onset and severity of acute kidney injury. However, in combination, a panel of kidney markers may serve as powerful tools in diagnosing kidney injury with high accuracy.

摘要

目的综述

近年来,急性肾损伤在急症治疗环境中越来越受到重视。对急性肾损伤患者进行正确的诊断和风险分层,对于开展适当和具有成本效益的治疗非常必要。肾脏标志物可作为诊断和预后工具,为医生提供更全面的肾脏损伤情况。本文的目的是强调一些最近研究中涉及肾脏标志物的证据,并就这些标志物的准确性提供当前的观点。

最新发现

最近的研究表明,新型肾脏标志物如胱抑素 C、白细胞介素-18、肾损伤分子 1 和中性粒细胞明胶酶相关脂质运载蛋白,与传统标志物肌酐相比,可作为急性肾损伤更准确的标志物。此外,每种标志物的浓度似乎与肾脏恶化程度、患者康复时间、住院时间和住院费用之间存在相关性。

总结

每种单独的肾脏标志物在确定急性肾损伤的发生和严重程度方面都有其自身的优势和局限性。然而,联合使用一组肾脏标志物可能成为诊断肾脏损伤的有力工具,具有较高的准确性。

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