Wong Jonathan, Kaja Kamal Raja Mohammed, Vilar Enric, Farrington Ken
Lister Renal Unit, Hertfordshire, United Kingdom.
University of Hertfordshire, United Kingdom.
Semin Dial. 2017 Jan;30(1):39-49. doi: 10.1111/sdi.12557. Epub 2016 Oct 18.
Many patients on hemodialysis retain significant residual renal function (RRF) but currently measurement of RRF in routine clinical practice can only be achieved using inter-dialytic urine collections to measure urea and creatinine clearances. Urine collections are difficult and inconvenient for patients and staff, and therefore RRF is not universally measured. Methods to assess RRF without reliance on urine collections are needed since RRF provides useful clinical and prognostic information and also permits the application of incremental hemodialysis techniques. Significant efforts have been made to explore the use of serum based biomarkers such as cystatin C, β-trace protein and β -microglobulin to estimate RRF. This article reviews blood-based biomarkers and novel methods using exogenous filtration markers which show potential in estimating RRF in hemodialysis patients without the need for urine collection.
许多接受血液透析的患者仍保留显著的残余肾功能（RRF），但目前在常规临床实践中，只能通过透析间期收集尿液来测量尿素和肌酐清除率，从而实现对RRF的测定。尿液收集对患者和工作人员来说既困难又不便，因此并非普遍对RRF进行测量。由于RRF能提供有用的临床和预后信息，还能应用递增血液透析技术，所以需要不依赖尿液收集来评估RRF的方法。人们已做出大量努力来探索使用基于血清的生物标志物，如胱抑素C、β-微量蛋白和β-微球蛋白来估算RRF。本文综述了基于血液的生物标志物以及使用外源性滤过标志物的新方法，这些方法在估算血液透析患者的RRF方面显示出潜力，且无需收集尿液。
