Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7022, Cincinnati, OH 45206, USA.
Crit Care. 2011 Aug 2;15(4):177. doi: 10.1186/cc10296.
Substantial basic and translational research has been directed to detect earlier and more sensitive acute kidney injury (AKI) biomarkers over the past decade. Much of the seminal AKI biomarker validation research has been performed in children undergoing cardiopulmonary bypass since they represent an ideal clinical model for AKI biomarker study: the timing of the injury is known and children do not have many of the co-morbidities seen in adult patient populations, which can confound the clinical situation. Ricci and colleagues report the results of their study using two novel urinary AKI biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C--not to predict AKI, but to define it--in a randomized trial of intraoperative fenoldopam to prevent AKI. They demonstrate that fenoldopam administration led to decreased postoperative urine NGAL and urine cystatin C concentrations, suggesting a renoprotective effect. Given the high sensitivity of NGAL for AKI post cardiopulmonary bypass, this study provides a model to use novel AKI biomarkers in a novel manner.
在过去的十年中，大量的基础和转化研究致力于发现更早、更敏感的急性肾损伤（AKI）生物标志物。由于儿童在体外循环下进行，他们代表了 AKI 生物标志物研究的理想临床模型：损伤的时间是已知的，而且儿童没有许多在成年患者群体中看到的合并症，这可能使临床情况复杂化。Ricci 及其同事报告了他们使用两种新型尿 AKI 生物标志物，中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和胱抑素 C，在一项预防 AKI 的术中使用 fenoldopam 的随机试验中的研究结果，这些标志物不是用于预测 AKI，而是用于定义 AKI。他们表明，fenoldopam 给药导致术后尿液 NGAL 和尿液胱抑素 C 浓度降低，表明有肾脏保护作用。鉴于 NGAL 在体外循环后对 AKI 的高敏感性，这项研究为使用新型 AKI 生物标志物提供了一种新的方法。
