尿液中一种酶对胰岛素样生长因子结合蛋白-1的裂解可预测急性肾损伤患者未来对肾脏替代治疗的需求。
CLEAVAGE OF IGFBP-1 BY AN ENZYME IN URINE PREDICTS THE FUTURE NEED FOR KIDNEY REPLACEMENT THERAPY IN ACUTE KIDNEY INJURY.
作者信息
Arthur John M, Holthoff Joseph H
机构信息
Little Rock, AR.
出版信息
Trans Am Clin Climatol Assoc. 2025;135:345-355.
The only Food and Drug Administration (FDA)-approved biomarker for prediction of acute kidney injury (AKI) in adults has a false positive rate (FPR) of 50%. We identified insulin-like growth factor-binding protein 1 (IGFBP-1) as a good but not great predictor of severe AKI. IGFBP-1 was cleaved by an enzyme in the urine. We tested the ability of IGFBP-1 cleavage to predict progression to dialysis. Urine from all 12 patients with stage 1 AKI that progressed to require dialysis cleaved the protein (100% sensitivity). FPR was 0% among healthy controls. FPRs among patients with stage 1 AKI at the time of collection were 11% for patients who did not progress beyond stage 1, 15% for patients who progressed to stage 2, and 50% for patients who progressed to stage 3 but did not require dialysis. The sensitivity of a test with these characteristics would be 100% in a typical intensive care unit (ICU) population, and the FPR would be 6%.
美国食品药品监督管理局（FDA）唯一批准的用于预测成人急性肾损伤（AKI）的生物标志物，其假阳性率（FPR）为50%。我们确定胰岛素样生长因子结合蛋白1（IGFBP-1）是严重AKI的一个较好但并非完美的预测指标。IGFBP-1在尿液中被一种酶切割。我们测试了IGFBP-1切割情况预测进展至透析的能力。所有12例进展至需要透析的1期AKI患者的尿液均能切割该蛋白（敏感性为100%）。健康对照者的FPR为0%。收集时处于1期AKI的患者中，未进展至1期以上的患者FPR为11%，进展至2期的患者FPR为15%，进展至3期但不需要透析的患者FPR为50%。具有这些特征的检测在典型的重症监护病房（ICU）人群中的敏感性将为100%，FPR将为6%。
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