Biomarkers in nephrology: Core Curriculum 2013.
Biomarkers in nephrology: Core Curriculum 2013.
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DOI：
10.1053/j.ajkd.2012.12.022
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Waikar SS
中科院分区：
文献类型：
--
作者：
McMahon GM;Waikar SS
几十年来，已知或疑似肾脏疾病患者的临床评估和管理一直受到生物标志物的帮助，美国国立卫生研究院（NIH）工作组将生物标志物定义为“作为正常生物过程，致病过程或对治疗干预的药理学反应的指标进行客观测量和评估的特征”。理想生物标志物的特征见方框1。从历史上看，肾脏疾病的第一个生物标志物是体格检查发现的间质性水肿或腹水，一种称为水肿的病症，其并不特异于最终被认为是肾衰竭的病症，而是包括许多临床病症，包括充血性心力衰竭和肝硬化。在早期的肾脏病学中，更客观的生物标志物包括尿沉渣检查，随后是血尿素氮浓度和血清肌酐浓度的测量。最近，在寻找更敏感、特异性和诊断准确的生物标志物以帮助肾病患者或有肾病风险的患者的护理方面，出现了爆炸性增长。在这篇综述中，我们的目的是讨论传统的和新的肾脏疾病的生物标志物在急性肾损伤（阿基），慢性肾脏疾病（CKD），肾毒素暴露和肾小球肾炎的设置。这些生物标志物沿着肾单位的解剖学定位如图1所示。
The clinical assessment and management of patients with known or suspected kidney disease has been aided for decades by biomarkers, a term defined by a National Institutes of Health (NIH) working group as “A characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacological responses to a therapeutic intervention.” The characteristics of an ideal biomarker are given in Box 1. Historically, the first biomarker of kidney disease was the finding on physical examination of interstitial edema or ascites, a condition termed dropsy, that was not specific to what eventually became recognized as kidney failure but that rather encompassed a number of clinical conditions including congestive heart failure and cirrhosis. More objective biomarkers in the early days of nephrology included the examination of the urine sediment, followed by measurement of the blood urea nitrogen concentration and the serum creatinine concentration.Recently, there has been an explosive growth in the search for more sensitive, specific, and prognostically accurate biomarkers to assist in the care of patients with or at risk of kidney disease. In this review we aim to discuss both conventional and novel biomarkers of kidney disease in the settings of acute kidney injury (AKI), chronic kidney disease (CKD), nephrotoxin exposure, and glomerulonephritis. An anatomical localization of these biomarkers along the nephron is shown in figure 1.
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