Advances in the use of multimarker panels for renal risk stratification.
Advances in the use of multimarker panels for renal risk stratification.
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DOI：
10.1097/mnh.0b013e328352132d
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发表时间：
2012-05
影响因子：
3.2
通讯作者：
Peralta CA
中科院分区：
文献类型：
--
作者：
Weekley CC;Peralta CA
本综述的目的是讨论去年的新研究，这些研究检查了使用多种标志物的组合来改善慢性肾脏疾病（CKD）的风险预测。我们将重点关注多标志物组，以改善CKD发病的预测;改善CKD的分类和CKD患者的风险分层;并制定进展为ESRD的个体水平风险评分。一项研究报告称，几种新的循环生物标志物可能有助于预测CKD和微量白蛋白尿的发生。第二，我们的研究小组已经表明，与单独使用肌酐相比，肌酐、胱抑素C和白蛋白尿联合使用可改善死亡、心力衰竭、心血管事件和终末期肾病的检测和风险分层。最后，开发了一种高度准确的个体风险评分，以使用现成的临床标志物预测进展为ESRD。多种标志物的组合可改善慢性肾病的检测和风险分层。未来的研究需要了解使用“肾脏面板”在不同人群中肾脏疾病的检测，分类和风险分层。本文介绍的研究代表了肾脏病学多标志物组范式转变的开始。
The purpose of this review is to discuss novel studies in the last year that have examined the use of combinations of multiple markers to improve risk prediction in the setting of chronic kidney disease (CKD). We will focus on multi-marker panels to improve prediction of CKD onset; improve classification of CKD and risk-stratification of persons with CKD; and develop individual-level risk scores for progression to ESRD. One study reported that several novel circulation biomarkers may aid in predicting incident CKD and microalbuminuria. Second, our group has shown that the combination of creatinine, cystatin C and albuminuria improves detection and risk stratification for death, heart failure, cardiovascular events, and end stage renal disease compared with creatinine alone. Finally, a highly accurate individual risk score was developed to predict progression to ESRD using readily available clinical markers. The combination of multiple markers improves detection and risk stratification in CKD. Future research is needed in understanding the use of a “renal panel” for detection, classification and risk stratification in kidney disease in diverse populations. The studies presented here represent the beginning of a paradigm shift to multi-marker panels in nephrology.