Department of Medicine, Division of Nephrology, Nephrology Research and Training Center and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Clin Transl Sci. 2012 Feb;5(1):93-101. doi: 10.1111/j.1752-8062.2011.00302.x. Epub 2011 Dec 7.
Acute kidney injury (AKI) is a common, heterogeneous, and detrimental clinical condition that has significant attributable morbidity and mortality. Despite major advances in understanding the epidemiology, pathogenesis, and outcomes of AKI, preventive measures remain inadequate and therapeutic approaches (except for renal replacement therapy) have largely proven futile so far. Critical to the process of designing rational therapies is translational research, which involves the transition between the basic research discoveries and everyday clinical applications to prevent, diagnose, and treat human diseases. Progress in innovative approaches has been hampered due in part to the reliance on functional markers (serum creatinine and blood urea nitrogen) that are neither sensitive nor specific to diagnose AKI. This limitation has created a great deal of interest and intense investigation to identify a "troponin-like marker" that would facilitate recognition of AKI and allow for timely implementation of the precise therapeutic agent. The other major obstacle in this field is the diverse and complex nature of AKI that involves multiple independent and overlapping pathways, making it difficult to cure AKI with a single approach. In this review, we will summarize the advances, ongoing studies, and future perspectives in the field of translational research of AKI.
急性肾损伤（AKI）是一种常见的、异质性的、有害的临床病症，具有显著的可归因发病率和死亡率。尽管在理解 AKI 的流行病学、发病机制和结局方面取得了重大进展，但预防措施仍然不足，治疗方法（除了肾脏替代疗法外）迄今为止基本上都没有效果。设计合理治疗方法的关键是转化研究，它涉及基础研究发现与日常临床应用之间的转变，以预防、诊断和治疗人类疾病。创新方法的进展受到阻碍，部分原因是依赖于功能标志物（血清肌酐和血尿素氮），这些标志物既不敏感也不特异，无法诊断 AKI。这一局限性引起了极大的兴趣和深入的研究，以确定一种“肌钙蛋白样标志物”，这将有助于识别 AKI，并及时实施精确的治疗剂。该领域的另一个主要障碍是 AKI 的多样性和复杂性，涉及多个独立和重叠的途径，因此很难用单一方法治愈 AKI。在这篇综述中，我们将总结 AKI 转化研究领域的进展、正在进行的研究和未来展望。
