Division of Clinical Analysis, Centro Universitário Saúde ABC, Santo André, Brazil.
Cardiology Department, Centro Universitário Saúde ABC, Santo André, Brazil.
Adv Exp Med Biol. 2021;1306:13-27. doi: 10.1007/978-3-030-63908-2_2.
Kidney diseases are conditions that increase the morbidity and mortality of those afflicted. Diagnosis of these conditions is based on parameters such as the glomerular filtration rate (GFR), measurement of serum and urinary creatinine levels and equations derived from these measurements (Wasung, Chawla, Madero. Clin Chim Acta 438:350-357, 2015). However, serum creatinine as a marker for measuring renal dysfunction has its limitations since it is altered in several other physiological situations, such as in patients with muscle loss, after intense physical exercise or in people on a high protein diet (Riley, Powers, Welch. Res Q Exerc Sport 52(3):339-347, 1981; Juraschek, Appel, Anderson, Miller. Am J Kidney Dis 61(4):547-554, 2013). Besides the fact that serum creatinine is a marker that indicates glomerular damage, it is necessary the discovery of new biomarkers that reflect not only glomerular damage but also tubular impairment. Recent advances in Molecular Biology have led to the generation or identification of new biomarkers for kidney diseases such as: Acute Kidney Failure (AKI), chronic kidney disease (CKD), nephritis or nephrotic syndrome. There are recent markers that have been used to aid in diagnosis and have been shown to be more sensitive and specific than classical markers, such as neutrophil gelatinase associated lipocalin (NGAL) or kidney injury molecule-1 (KIM-1) (Wasung, Chawla, Madero. Clin Chim Acta 438:350-357, 2015; George, Gounden. Adv Clin Chem 88:91-119, 2019; Han, Bailly, Abichandani, Thadhani, Bonventre. Kidney Int 62(1):237-244, 2002; Fontanilla, Han. Expert Opin Med Diagn 5(2):161-173, 2011). However, early diagnostic biomarkers are still necessary to assist the intervention and monitor of the progression of these conditions.
肾脏疾病会增加患者的发病率和死亡率。这些疾病的诊断基于肾小球滤过率（GFR）等参数，以及血清和尿液肌酐水平的测量和由此得出的计算公式（Wasung、Chawla、Madero，Clin Chim Acta 438:350-357, 2015）。然而，血清肌酐作为衡量肾功能障碍的标志物存在局限性，因为它在许多其他生理情况下也会发生变化，例如肌肉减少的患者、剧烈运动后或高蛋白饮食的人群（Riley、Powers、Welch，Res Q Exerc Sport 52(3):339-347, 1981；Juraschek、Appel、Anderson、Miller，Am J Kidney Dis 61(4):547-554, 2013）。除了血清肌酐是一种表明肾小球损伤的标志物这一事实之外，还需要发现新的生物标志物，这些标志物不仅反映肾小球损伤，还反映肾小管损伤。分子生物学的最新进展导致了新的肾脏疾病生物标志物的产生或鉴定，例如：急性肾损伤（AKI）、慢性肾脏病（CKD）、肾炎或肾病综合征。目前有一些新的标志物已被用于辅助诊断，并且比传统标志物更敏感和特异，例如中性粒细胞明胶酶相关脂质运载蛋白（NGAL）或肾损伤分子-1（KIM-1）（Wasung、Chawla、Madero，Clin Chim Acta 438:350-357, 2015；George、Gounden，Adv Clin Chem 88:91-119, 2019；Han、Bailly、Abichandani、Thadhani、Bonventre，Kidney Int 62(1):237-244, 2002；Fontanilla、Han，Expert Opin Med Diagn 5(2):161-173, 2011）。然而，仍然需要早期诊断生物标志物来辅助干预和监测这些疾病的进展。
