Gaião Sérgio Mina, Paiva José Artur Osório de Carvalho
Department of Emergency and Intensive Care, Centro Hospitalar São João, Faculdade de Medicina, Universidade do Porto - Porto, Portugal.
Infection and Sepsis Group - Centro Hospitalar São João, Faculdade de Medicina, Universidade do Porto - Porto, Portugal.
Rev Bras Ter Intensiva. 2017 Jul-Sep;29(3):373-381. doi: 10.5935/0103-507X.20170051.
Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery. The reference lists of these articles and relevant review articles were also reviewed. Final references were selected for inclusion in the review based on their relevance. New biomarkers exhibited a potential role in the early diagnosis of acute kidney injury recovery. Urine HGF, IGFBP-7, TIMP-2 and NGAL may improve our ability to predict the odds and timing of recovery and eventually renal support withdrawal. Acute kidney injury recovery requires more study, and its definition needs to be standardized to allow for better and more powerful research on biomarkers because some of them show potential for the prediction of acute kidney injury recovery.
新型生物标志物可能适用于急性肾损伤的早期诊断以及透析需求的预测。目前尚不清楚此类生物标志物在已确诊的急性肾损伤后的恢复预测中是否也发挥作用，或者在辅助决定何时停止肾脏支持治疗方面是否有作用。我们检索了PubMed、科学网和谷歌学术，查找有关急性肾损伤后肾脏恢复的流行病学、急性肾损伤后恢复与未恢复的风险因素以及急性肾损伤恢复的潜在生物标志物的研究。这些文章的参考文献列表以及相关综述文章也进行了审查。根据相关性选择最终参考文献纳入综述。新的生物标志物在急性肾损伤恢复的早期诊断中显示出潜在作用。尿肝细胞生长因子（HGF）、胰岛素样生长因子结合蛋白7（IGFBP - 7）、基质金属蛋白酶组织抑制因子2（TIMP - 2）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）可能会提高我们预测恢复几率和时间以及最终停止肾脏支持治疗的能力。急性肾损伤的恢复需要更多研究，其定义需要标准化，以便对生物标志物进行更好、更有力的研究，因为其中一些生物标志物显示出预测急性肾损伤恢复的潜力。
