前脑啡肽原A在重症监护中的应用与一年评估

Implementation and One-Year Evaluation of Proenkephalin A in Critical Care.

作者信息

Martin Lukas, Martin Caren, Peine Arne, Imöhl Matthias, Kersten Alexander, Kramann Rafael, Saritas Turgay, Marx Nikolaus, Dreher Michael, Marx Gernot, Simon Tim-Philipp

机构信息

Department of Intensive Care Medicine, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany.

Laboratory Diagnostic Center, University Hospital RWTH Aachen, 52074 Aachen, Germany.

出版信息

Int J Mol Sci. 2025 Mar 13;26(6):2602. doi: 10.3390/ijms26062602.

DOI:10.3390/ijms26062602

PMID:40141244

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11942029/

Abstract

Proenkephalin A 119-159 (PENK) is a promising functional kidney biomarker, evaluated in various clinical settings. In critical care medicine, early diagnosis of acute kidney injury (AKI) is crucial; however, to date, the diagnosis and the assessment of kidney function is still based on serum creatinine (sCr) and urine output, both associated with several limitations. Between November 2020 and March 2022, we implemented PENK in our daily practice on our intensive care units (ICU). PENK, sCr, AKI stage, and the start and duration of renal replacement therapy (RRT) were documented. Almost 18,000 PENK measurements from 4169 patients were analyzed, and the glomerular filtration rate (GFR) was estimated with the new PENK-GFR formula. PENK outperformed sCR in the kidney function assessment and sCR trajectory over time. Moreover, PENK predicted the use of RRT and thus showed its usefulness in critical care daily practice.

摘要

前脑啡肽原A 119 - 159（PENK）是一种很有前景的功能性肾脏生物标志物，已在各种临床环境中进行评估。在重症医学中，急性肾损伤（AKI）的早期诊断至关重要；然而，迄今为止，肾功能的诊断和评估仍基于血清肌酐（sCr）和尿量，这两者都存在一些局限性。在2020年11月至2022年3月期间，我们在重症监护病房（ICU）的日常工作中应用了PENK。记录了PENK、sCr、AKI分期以及肾脏替代治疗（RRT）的开始时间和持续时间。分析了来自4169例患者的近18000次PENK测量值，并使用新的PENK - GFR公式估算了肾小球滤过率（GFR）。在肾功能评估和sCr随时间的变化轨迹方面，PENK优于sCR。此外，PENK预测了RRT的使用情况，因此显示出其在重症监护日常工作中的实用性。