Sanjeevani Scienthia, Pruthi Sonal, Kalra Sarathi, Goel Ashish, Kalra Om Prakash
Department of Nephrology and Internal Medicine, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India.
Department of Internal Medicine, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India.
Int J Crit Illn Inj Sci. 2014 Jul;4(3):223-8. doi: 10.4103/2229-5151.141420.
Acute kidney injury (AKI) is characterized by abrupt or rapid decline of renal function and is usually associated with the development of serious complications as well as an independent risk of mortality in hospitalized patients. Emergency physicians play a critical role in recognizing early AKI, preventing iatrogenic injury, and reversing the course of AKI. Among the various available biomarkers for AKI, reliable and automated assay methods are commercially available for only cystatin-C and neutrophil gelatinase-associated lipocalin (NGAL). NGAL appears to be a promising marker for early detection of AKI and is likely to be adapted for wide-scale clinical use in patient management as a point-of-care test. Use of NGAL along with panel of other renal biomarkers can improve the rate of early detection of AKI. Large, multicenter studies demonstrate the association between biomarkers and hard end points such as need for renal replacement therapy (RRT), cardiovascular events, hospital stay, and death, independent of serum creatinine concentrations.
急性肾损伤（AKI）的特征是肾功能突然或快速下降，通常与严重并发症的发生以及住院患者的独立死亡风险相关。急诊医生在早期识别AKI、预防医源性损伤以及扭转AKI病程方面发挥着关键作用。在AKI的各种可用生物标志物中，只有胱抑素C和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）有可靠且自动化的检测方法可供商业使用。NGAL似乎是早期检测AKI的一个有前景的标志物，并且很可能作为即时检验被广泛应用于患者管理的临床实践中。将NGAL与其他肾脏生物标志物组合使用可以提高AKI的早期检测率。大型多中心研究表明，生物标志物与诸如肾脏替代治疗（RRT）需求、心血管事件、住院时间和死亡等硬终点之间存在关联，且独立于血清肌酐浓度。
