Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Nephrol Hypertens. 2019 Nov;28(6):560-566. doi: 10.1097/MNH.0000000000000538.
Serum creatinine and urine output continue to be the mainstays of diagnosis of acute kidney injury, though both of these measures have significant limitations, especially in acutely hospitalized patients. Biomarkers in both blood and urine have been studied extensively in the research setting and are on the verge of clinical practice to improve diagnosis of AKI.
Blood and urine biomarkers can be localized to specific areas or functions within the nephron. Biomarkers can help to characterize glomerular or tubular function; glomerular, tubular, or interstitial injury; inflammation; or repair. Further, biomarkers can improve diagnosis of AKI in various clinical settings including acute interstitial nephritis, acute tubular injury, and hepatorenal syndrome, and cardiorenal syndrome.
Biomarkers are becoming more prevalent in both research and getting close to clinical use. Both blood and urine biomarkers can help to localize impairment in nephron health by either location or function within the nephron and among various causes of AKI.
血清肌酐和尿量仍是急性肾损伤诊断的主要依据，但这两种方法都有明显的局限性，尤其是在急性住院患者中。血液和尿液中的生物标志物在研究中已得到广泛研究，并且即将在临床上应用于改善 AKI 的诊断。
血液和尿液生物标志物可定位于肾单位内的特定区域或功能。生物标志物可以帮助表征肾小球或肾小管功能；肾小球、肾小管或间质性损伤；炎症；或修复。此外，生物标志物可改善急性间质性肾炎、急性肾小管损伤和肝肾综合征以及心肾综合征等各种临床情况下 AKI 的诊断。
生物标志物在研究和临床应用中越来越普遍。血液和尿液生物标志物都可以通过位置或肾单位内的功能以及 AKI 的各种原因来帮助定位肾单位健康受损。
