UNASSIGNED: The authors discuss the diagnostic and predictive utilities of serum and urinary biomarkers on AKI and on the risk of AKI-to-CKD progression. The authors focus on the relevant literature covering evidence of circulating and urinary biomarkers\' capability to predict the transition of AKI to CKD.
UNASSIGNED: Based on the different modalities of serum and urinary biomarkers, multiple biomarker panel seems to be potentially useful to distinguish between various types of AKI, to detect the severity and the risk of AKI progression, to predict the clinical outcome and evaluate response to the therapy. Serum/urinary neutrophil gelatinase-associated lipocalin (NGAL), serum/urinary uromodulin, serum extracellular high mobility group box-1 (HMGB-1), serum cystatin C and urinary liver-type fatty acid-binding protein (L-FABP) were the most effective in the prediction of AKI-to-CKD transition regardless of etiology and the presence of critical state in patients. The current clinical evidence on the risk assessments of AKI progression is mainly based on the utility of combination of functional, injury and stress biomarkers, mainly NGAL, L-FABP, HMGB-1 and cystatin C.
■作者讨论了血清和尿生物标志物对AKI和AKI至CKD进展风险的诊断和预测效用。作者重点关注相关文献,涵盖循环和尿液生物标志物预测AKI向CKD转变的能力的证据。
■基于血清和尿液生物标志物的不同模式,多个生物标志物组似乎可能有助于区分各种类型的AKI,为了检测AKI进展的严重程度和风险,预测临床结果并评估对治疗的反应。血清/尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL),血清/尿调节素,血清细胞外高迁移率族蛋白-1(HMGB-1),血清胱抑素C和尿肝型脂肪酸结合蛋白(L-FABP)在预测AKI向CKD转变方面最有效,无论患者的病因和是否存在危重状态.目前关于AKI进展风险评估的临床证据主要基于功能组合的效用,损伤和压力生物标志物,主要是NGAL,L-FABP,HMGB-1和胱抑素C.