Chaykovska Lyubov, Tsuprykov Oleg, Hocher Berthold
Charité - Universitätsmedizin Berlin, Center for Cardiovascular Research, Institute for Pharmacology and Toxicology, Berlin, Germany.
Clin Lab. 2011;57(7-8):455-67.
The mortality of end-stage renal disease (ESRD) patients on dialysis remains high despite great improvement of dialysis technologies in the past decades. These patients die due to infectious diseases (mainly sepsis), cardiovascular diseases such as myocardial infarction, heart failure, stroke, and, in particular, sudden cardiac death. End stage renal disease is a complex condition, where the failure of kidney function is accompanied by numerous metabolic changes affecting almost all organ systems of the human body. Many of the biomarker characteristics of the individually affected organ systems have been associated with adverse outcomes. These biomarkers are different in patients with ESRD compared to the general population in the prediction of morbidity and mortality. Biomarker research in this field should aim to identify patients at risk for the different disease entities. Traditional biomarkers such as CRP, BNP, and troponins as well as new biomarkers such as fetuin, CD154, and relaxin were analyzed in patients on dialysis. We will include observational as well as prospective clinical trials in this review. Furthermore, we will also discuss proteomics biomarker studies. The article assess the potential diagnostic value of different biomarkers in daily clinical practice as well as their usefulness for clinical drug development in end stage renal disease patients.
尽管在过去几十年里透析技术有了很大改进，但接受透析的终末期肾病（ESRD）患者的死亡率仍然很高。这些患者死于传染病（主要是败血症）、心血管疾病，如心肌梗死、心力衰竭、中风，尤其是心源性猝死。终末期肾病是一种复杂的病症，肾功能衰竭伴随着影响人体几乎所有器官系统的众多代谢变化。各个受影响器官系统的许多生物标志物特征都与不良后果相关。与普通人群相比，ESRD患者的这些生物标志物在发病率和死亡率预测方面有所不同。该领域的生物标志物研究应旨在识别不同疾病实体的高危患者。对透析患者分析了传统生物标志物，如CRP、BNP和肌钙蛋白，以及新的生物标志物，如胎球蛋白、CD154和松弛素。本综述将纳入观察性以及前瞻性临床试验。此外，我们还将讨论蛋白质组学生物标志物研究。本文评估了不同生物标志物在日常临床实践中的潜在诊断价值及其对终末期肾病患者临床药物开发的有用性。
