Kidney Health Research Collaborative, University of California San Francisco School of Medicine, San Francisco, California 94121, USA.
Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA; email:
Annu Rev Physiol. 2019 Feb 10;81:309-333. doi: 10.1146/annurev-physiol-020518-114605.
The current unidimensional paradigm of kidney disease detection is incompatible with the complexity and heterogeneity of renal pathology. The diagnosis of kidney disease has largely focused on glomerular filtration, while assessment of kidney tubular health has notably been absent. Following insult, the kidney tubular cells undergo a cascade of cellular responses that result in the production and accumulation of low-molecular-weight proteins in the urine and systemic circulation. Modern advancements in molecular analysis and proteomics have allowed the identification and quantification of these proteins as biomarkers for assessing and characterizing kidney diseases. In this review, we highlight promising biomarkers of kidney tubular health that have strong underpinnings in the pathophysiology of kidney disease. These biomarkers have been applied to various specific clinical settings from the spectrum of acute to chronic kidney diseases, demonstrating the potential to improve patient care.
目前,肾脏疾病检测的单一维度范式与肾脏病理学的复杂性和异质性不兼容。肾脏疾病的诊断主要集中在肾小球滤过功能上,而肾小管健康的评估明显缺失。在受到损伤后,肾小管细胞会经历一系列的细胞反应,导致低分子量蛋白质在尿液和全身循环中积累。分子分析和蛋白质组学的现代进展使得这些蛋白质可以作为生物标志物被识别和定量,用于评估和描述肾脏疾病。在这篇综述中,我们重点介绍了具有肾脏疾病病理生理学坚实基础的肾小管健康的有前途的生物标志物。这些生物标志物已应用于从急性到慢性肾脏病的各种特定临床环境中,显示出改善患者护理的潜力。
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