Applications of cardiac biomarkers in chronic kidney disease.
Applications of cardiac biomarkers in chronic kidney disease.
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DOI：
10.1097/mnh.0000000000000829
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发表时间：
2022-11-01
影响因子：
3.2
通讯作者：
Bansal, Nisha
中科院分区：
文献类型：
--
作者：
Kula, Alexander;Bansal, Nisha
心血管疾病是慢性肾脏疾病（CKD）患者死亡的主要原因。连接CKD和心血管疾病的机制是复杂的，血清生物标志物可以帮助提高我们的理解。Nt-proBNP和肌钙蛋白已被证明是诊断心血管疾病的生物标志物，并为非ckd人群提供了机制见解。本综述的目的是总结Nt-proBNP和肌钙蛋白在CKD患者中的疗效和临床应用潜力的证据。我们对Nt-proBNP和肌钙蛋白如何在CKD患者中解释的理解正在不断发展。虽然这两种生物标志物都部分被肾脏清除，但水平升高主要反映心血管病理。Nt-proBNP和肌钙蛋白都与CKD患者未来心血管事件的风险相关。确定ckd特异性截止点并使用生物标志物指导治疗仍在积极研究中。在许多正在研究的血清生物标志物中，Nt-proBNP和肌钙蛋白最符合CKD有效生物标志物的标准。检测方法广泛可用，并且在CKD人群中被证明是准确的。Nt-proBNP和肌钙蛋白在CKD中降低心血管风险的研究中值得特别关注。特别是，识别高危患者，建议靶向机制，评估治疗效果。
Cardiovascular disease is the leading cause of death in individuals with chronic kidney disease (CKD). The mechanisms connecting CKD and cardiovascular disease are complex, and serum biomarkers can help improve our understanding. Nt-proBNP and troponin have documented success as biomarkers to diagnose and CVD and provide mechanistic insights in non-CKD populations. The purpose of this review is to summarize evidence suggesting efficacy and potential for clinical application of Nt-proBNP and troponin in individuals with CKD. Our understanding of how Nt-proBNP and Troponin should be interpreted in those with CKD is evolving. While both biomarkers are in part cleared by the kidney, elevated levels predominantly reflect cardiovascular pathology. Both Nt-proBNP and troponin are associated with risk for future cardiovascular events in CKD. Determining CKD-specific cutoffs and using biomarkers to guide therapy remains under active investigation. Of the many serum biomarkers under investigation, Nt-proBNP and troponin best meet the criteria for effective biomarkers in CKD. Assays are widely available and proven to be accurate in CKD populations. Nt-proBNP and troponin deserve special focus in ongoing research of cardiovascular risk reduction in CKD. Especially, to identify patients at highest risk, suggest targetable mechanisms, and assess treatment efficacy.