Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Curr Opin Crit Care. 2024 Dec 1;30(6):555-562. doi: 10.1097/MCC.0000000000001212. Epub 2024 Sep 13.
This review discusses novel concepts of acute kidney injury (AKI), including subphenotyping, which may facilitate the development of target treatment strategies for specific subgroups of patients to achieve precision medicine.
AKI is a multifaceted syndrome with a major impact on morbidity and mortality. As efforts to identify treatment strategies have largely failed, it is becoming increasingly apparent that there are different subphenotypes that require different treatment strategies. Various ways of subphenotyping AKI have been investigated, including the use of novel renal biomarkers, machine learning and artificial intelligence, some of which have already been implemented in the clinical setting. Thus, novel renal biomarkers have been recommended for inclusion in new definition criteria for AKI and for the use of biomarker bundled strategies for the prevention of AKI. Computational models have been explored and require future research.
Subphenotyping of AKI may provide a new understanding of this syndrome and guide targeted treatment strategies in order to improve patient outcomes.
本篇综述讨论了急性肾损伤 (AKI) 的新概念,包括亚表型,这可能有助于为特定亚组患者制定靶向治疗策略,以实现精准医学。
AKI 是一种多方面的综合征,对发病率和死亡率有重大影响。由于寻找治疗策略的努力在很大程度上失败了,因此越来越明显的是,存在不同的亚表型,需要不同的治疗策略。已经研究了 AKI 的各种亚表型方法,包括使用新型肾脏生物标志物、机器学习和人工智能,其中一些已经在临床环境中实施。因此,新型肾脏生物标志物已被推荐纳入 AKI 的新定义标准,并用于预防 AKI 的生物标志物联合策略。已经探索了计算模型,需要进一步的研究。
AKI 的亚表型可能为该综合征提供新的认识,并指导靶向治疗策略,以改善患者的预后。