Ogorevc Nace, Slak Peter, Nikšić Stevan, Novljan Gregor, Fister Petja, Plut Domen
Clinical Radiology Institute, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
Children (Basel). 2024 Sep 30;11(10):1205. doi: 10.3390/children11101205.
Acute kidney injury (AKI) is an acute condition of impaired kidney function with decreased glomerular filtration rate, which results in dysregulation in volume, electrolyte, and acid-base equilibrium. AKI can be a life-threatening condition and can also lead to chronic kidney disease. It is important to diagnose AKI early in the course of the disease or to predict its development, as this can influence therapeutic decisions, outcome, and, consequently, the prognosis. In clinical practice, an elevated serum creatinine concentration remains the most common laboratory indicator for diagnosing AKI. However, due to the delay in its rise, creatinine levels are often insensitive and inaccurate for early diagnosis. Novel biomarkers of kidney tubular injury and the renal angina index have shown promise in predicting AKI earlier and more accurately. Contrast-enhanced ultrasonography (CEUS) and ultra-microangiography (UMA) are radiological methods that can quantify renal microperfusion and may be able to predict the development of AKI. They have not yet been used for quantifying renal perfusion in children with risk factors for developing AKI. Further research is needed to compare these sonographic techniques with the renal angina index and emerging kidney injury biomarkers for predicting acute kidney injury (AKI) in both children and adults.
急性肾损伤（AKI）是一种肾功能受损的急性病症，肾小球滤过率降低，导致容量、电解质及酸碱平衡失调。AKI可能危及生命，还可能导致慢性肾病。在疾病进程中尽早诊断AKI或预测其发展非常重要，因为这会影响治疗决策、治疗结果以及预后。在临床实践中，血清肌酐浓度升高仍是诊断AKI最常用的实验室指标。然而，由于肌酐水平升高出现延迟，其对于早期诊断往往不敏感且不准确。新型肾小管损伤生物标志物和肾绞痛指数在更早、更准确地预测AKI方面显示出前景。对比增强超声检查（CEUS）和超微血管造影（UMA）是能够量化肾微血管灌注的放射学方法，或许能够预测AKI的发展。它们尚未用于对有发生AKI风险因素的儿童进行肾灌注量化。需要进一步开展研究，以将这些超声技术与肾绞痛指数及新出现的肾损伤生物标志物进行比较，从而在儿童和成人中预测急性肾损伤（AKI）。
