Department of Nephrology, Hypertension, Diabetes and Endocrinology, Otto-von-Guericke-University, Leipziger Strasse 44, 39120 Magdeburg, Germany.
Nat Rev Nephrol. 2012 Dec;8(12):735-9. doi: 10.1038/nrneph.2012.197. Epub 2012 Sep 25.
According to guidelines published by Kidney Disease: Improving Global Outcomes, patients at risk of acute kidney injury (AKI) should be managed according to their susceptibilities and exposures. Clinical evaluation of a patient's risk of acute loss of renal function is of undisputed importance. However, such evaluations can be hindered by the complex presentations of critically ill patients and the lack of methods to detect early kidney damage. In this regard, a tool for diagnosis and stratification of patients at risk of AKI would complement clinical assessments and enable improved therapeutic decision-making. Emerging evidence suggests that 15-20% of patients who do not fulfil current serum-creatinine-based consensus criteria for AKI are nevertheless likely to have acute tubular damage, which is associated with adverse outcomes. This evidence supports reassessment of the concept and evolution of the definition of AKI to incorporate biomarkers of tubular damage.
改善全球预后组织发布的指南，有发生急性肾损伤（AKI）风险的患者应根据其易感性和暴露情况进行管理。对患者发生急性肾功能丧失风险的临床评估具有非常重要的意义。然而，危重病患者的复杂表现和缺乏早期肾损伤检测方法可能会对评估造成阻碍。在这方面，一种用于诊断和分层 AKI 风险患者的工具可以补充临床评估，并能够做出更好的治疗决策。新出现的证据表明，尽管当前基于血清肌酐的 AKI 共识标准未能满足，但仍有 15-20%的患者可能发生急性肾小管损伤，这与不良预后有关。这一证据支持重新评估 AKI 的概念和定义演变，以纳入肾小管损伤的生物标志物。
