Karvellas Constantine J, Durand Francois, Nadim Mitra K
Division of Critical Care Medicine, University of Alberta, 1-40 Zeidler Ledcor Building, 8540, 112 Street, Edmonton, Alberta T6G 2X8, Canada; Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Service d'Hépatologie & Réanimation Hépatodigestive, Hepatology and Liver Intensive Care Unit, INSERM U773, Université Paris VII Hôpital Beaujon, 100 Boulevard du Général Leclerc, Clichy 92110, France; INSERM U1149, University Paris VII, Denis Diderot, Paris, France.
Crit Care Clin. 2015 Oct;31(4):737-50. doi: 10.1016/j.ccc.2015.06.009. Epub 2015 Aug 5.
Acute kidney injury (AKI) is a frequent complication of end-stage liver disease, especially in those with acute-on-chronic liver failure, occurring in up to 50% of hospitalized patients with cirrhosis. There is no specific blood or urine biomarker that can reliably identify the cause of AKI in cirrhotic patients. This review examines studies used to assess renal dysfunction in cirrhotic patients including new diagnostic criteria and potential novel biomarkers. Although biomarker development to differentiate the cause of AKI in cirrhosis has promise, the utility of biomarkers to determine irreversible renal dysfunction with liver transplant remains lacking, warranting further investigation.
急性肾损伤（AKI）是终末期肝病的常见并发症，尤其是在那些急性慢性肝衰竭患者中，在高达50%的肝硬化住院患者中发生。没有特定的血液或尿液生物标志物能够可靠地识别肝硬化患者急性肾损伤的病因。本综述考察了用于评估肝硬化患者肾功能障碍的研究，包括新的诊断标准和潜在的新型生物标志物。尽管开发用于区分肝硬化中急性肾损伤病因的生物标志物具有前景，但仍缺乏生物标志物用于确定肝移植后不可逆肾功能障碍的效用，这值得进一步研究。
