Manguba Alexander S, Vela Parada Xavier, Coca Steven G, Lala Anuradha
Department of Medicine, Icahn School of Medicine at Mount Sinai/St. Luke's-Roosevelt Hospital Center, New York, NY, USA.
Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Curr Heart Fail Rep. 2019 Dec;16(6):257-273. doi: 10.1007/s11897-019-00448-9.
This review discusses evidence that has accumulated over the years on the diagnostic and prognostic utility of biomarkers of kidney injury in the setting of acute decompensated heart failure.
Despite numerous studies evaluating several different biomarkers both in the serum and urine, the current body of evidence does not support routine use of any of these biomarkers for the purposes of diagnosis of acute kidney injury or for prognosis after hospitalization for acute decompensated heart failure. All studies are observational in nature and, as such, are likely limited by numerous confounders, the most important of which is modification of decongestive therapy in response to worsening renal function. More recent evidence suggests that worsening renal function or kidney injury does not always portend poor outcomes after hospitalization for heart failure. There is currently no conclusive evidence to recommend the routine use of biomarkers of kidney injury in acute decompensated heart failure.
本综述讨论了多年来积累的关于急性失代偿性心力衰竭患者中肾损伤生物标志物的诊断和预后效用的证据。
尽管有大量研究评估了血清和尿液中的几种不同生物标志物，但目前的证据并不支持将这些生物标志物中的任何一种常规用于急性肾损伤的诊断或急性失代偿性心力衰竭住院后的预后评估。所有研究本质上都是观察性的，因此可能受到众多混杂因素的限制，其中最重要的是因肾功能恶化而调整的去充血治疗。最新证据表明，肾功能恶化或肾损伤并不总是预示着心力衰竭住院后的不良结局。目前尚无确凿证据推荐在急性失代偿性心力衰竭中常规使用肾损伤生物标志物。
