Yousef Almulhim Mohammed
College of Medicine, King Faisal University, Alahsa, Saudi Arabia.
PLoS One. 2025 Jan 29;20(1):e0311755. doi: 10.1371/journal.pone.0311755. eCollection 2025.
Acute kidney injury (AKI) is a frequent clinical complication lacking early diagnostic tests and effective treatments. Novel biomarkers have shown promise for enabling earlier detection, risk stratification, and guiding management of AKI. We conducted a systematic review to synthesize evidence on the efficacy of novel biomarkers for AKI detection and management. Database searches yielded 17 relevant studies which were critically appraised. Key themes were biomarker efficacy in predicting AKI risk and severity before functional changes; potential to improve clinical management through earlier diagnosis, prognostic enrichment, and guiding interventions; emerging roles as therapeutic targets and prognostic tools; and ongoing challenges requiring further validation. Overall, novel biomarkers like neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cell cycle arrest markers ([TIMP-2] •[IGFBP7]) demonstrate capability for very early AKI prediction and accurate risk stratification. Their incorporation has potential to facilitate timely targeted interventions and personalized management. However, factors influencing biomarker performance, optimal cutoffs, cost-effectiveness, and impact on patient outcomes require robust validation across diverse settings before widespread implementation. Addressing these limitations through ongoing research can help translate novel biomarkers into improved detection, prognosis, and management of AKI in clinical practice.
急性肾损伤(AKI)是一种常见的临床并发症,缺乏早期诊断测试和有效治疗方法。新型生物标志物已显示出有望实现AKI的早期检测、风险分层及指导治疗。我们进行了一项系统综述,以综合关于新型生物标志物在AKI检测和治疗中疗效的证据。数据库检索产生了17项相关研究,并对其进行了严格评估。关键主题包括生物标志物在功能改变前预测AKI风险和严重程度的疗效;通过早期诊断、预后富集和指导干预改善临床管理的潜力;作为治疗靶点和预后工具的新作用;以及需要进一步验证的持续挑战。总体而言,中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)和细胞周期停滞标志物([TIMP-2]•[IGFBP7])等新型生物标志物显示出极早期预测AKI及准确进行风险分层的能力。将它们纳入其中有可能促进及时的靶向干预和个性化管理。然而,在广泛应用之前,影响生物标志物性能的因素、最佳临界值、成本效益以及对患者预后的影响需要在不同环境中进行有力验证。通过持续研究解决这些局限性有助于将新型生物标志物转化为临床实践中改善AKI检测、预后和管理的方法。
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