尿水通道蛋白2对急性失代偿性心力衰竭患者急性肾损伤的预测价值

Predictive Value of Urinary Aquaporin 2 for Acute Kidney Injury in Patients with Acute Decompensated Heart Failure.

作者信息

Chan Ming-Jen, Chen Yung-Chang, Fan Pei-Chun, Lee Cheng-Chia, Kou George, Chang Chih-Hsiang

机构信息

Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.

出版信息

Biomedicines. 2022 Mar 6;10(3):613. doi: 10.3390/biomedicines10030613.

DOI:10.3390/biomedicines10030613

PMID:35327416

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8945460/

Abstract

Acute kidney injury (AKI) is frequently encountered in people with acute decompensated heart failure (ADHF) and is associated with increased morbidity and mortality. Early detection of a urinary biomarker of kidney injury might allow a prompt diagnosis and improve outcomes. Levels of urinary aquaporin 2 (UAQP2), which is also associated with several renal diseases, are increased with ADHF. We aimed to determine whether UAQP2 predicted AKI in patients with ADHF. We conducted a prospective observation study in the coronary care unit (CCU) in a tertiary care university hospital in Taiwan. Individuals with ADHF admitted to the CCU between November 2009 and November 2014 were enrolled, and serum and urinary samples were collected. AKI was diagnosed in 69 (36.5%) of 189 adult patients (mean age: 68 years). Area under the receiver operating characteristic curve (AUROC) of biomarkers was evaluated to evaluate the diagnostic power for AKI. Both brain natriuretic peptide and UAQP2 demonstrated acceptable AUROCs (0.759 and 0.795, respectively). A combination of the markers had an AUROC of 0.802. UAQP2 is a potential biomarker of AKI in CCU patients with ADHF. Additional research on this novel biomarker is required.

摘要

急性肾损伤（AKI）在急性失代偿性心力衰竭（ADHF）患者中经常出现，并且与发病率和死亡率的增加相关。早期检测肾脏损伤的尿液生物标志物可能有助于及时诊断并改善预后。与几种肾脏疾病也相关的尿水通道蛋白2（UAQP2）水平在ADHF患者中会升高。我们旨在确定UAQP2是否能预测ADHF患者的AKI。我们在台湾一所三级医疗大学医院的冠心病监护病房（CCU）进行了一项前瞻性观察研究。纳入了2009年11月至2014年11月期间入住CCU的ADHF患者，并采集了血清和尿液样本。189例成年患者（平均年龄：68岁）中有69例（36.5%）被诊断为AKI。评估生物标志物的受试者工作特征曲线下面积（AUROC）以评估其对AKI的诊断能力。脑钠肽和UAQP2的AUROC均达到可接受水平（分别为0.759和0.795）。两种标志物联合使用时AUROC为0.802。UAQP2是CCU中ADHF患者AKI的潜在生物标志物。需要对这种新型生物标志物进行更多研究。