Urinary biomarkers for early diabetic nephropathy: beyond albuminuria.
Urinary biomarkers for early diabetic nephropathy: beyond albuminuria.
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DOI：
10.1007/s00467-014-2888-2
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发表时间：
2015-07
影响因子：
3
通讯作者：
Choi, Mary E.
中科院分区：
文献类型：
--
作者：
Lee, So-Young;Choi, Mary E.
糖尿病肾病（DN）是美国终末期肾病最常见的原因，并导致糖尿病患者发病率和死亡率显著增加。早期发现对于改善临床管理至关重要。尽管微量白蛋白尿被认为是诊断DN的金标准，但其预测能力有限。近年来，人们一直在努力寻找更好的策略来检测糖尿病患者的早期DN和进行性肾功能下降。在这里，我们回顾了各种尿液生物标志物，这些生物标志物已经出现，并有望更敏感地早期检测糖尿病肾病和预测进展为终末期肾病。已经鉴定了尿液中存在的许多关键生物标志物，其反映了肾单位沿着特定部位的肾损伤，包括肾小球/足细胞损伤和肾小管损伤、氧化应激、炎症和肾内肾素-血管紧张素系统的活化。此外，我们描述了新的方法，包括尿microRNA，这是短的非编码mRNA，调节基因表达，尿蛋白质组学用于确定潜在的新的生物标志物在糖尿病肾病的发展和进展。
Diabetic nephropathy (DN) is the most common cause of end-stage kidney disease in the United States, and accounts for a significant increase in morbidity and mortality in patients with diabetes. Early detection is critical in improving clinical management. Although microalbuminuria is regarded as the gold standard for diagnosing onset of DN, its predictive powers are limited. There have been great efforts in recent years to identify better strategies for the detection of early stages of DN and progressive kidney function decline in diabetic patients. Here, we review various urinary biomarkers that have emerged and hold promise to be more sensitive for earlier detection of diabetic kidney disease and predictive of progression to end-stage kidney disease. A number of key biomarkers present in the urine have been identified that reflect kidney injury at specific sites along the nephron, including glomerular/podocyte damage and tubular damage, oxidative stress, inflammation, and activation of the intrarenal renin-angiotensin system. Moreover, we describe newer approaches including urinary microRNAs, which are short noncoding mRNAs that regulate gene expression, and urine proteomics used to identify potential novel biomarkers in the development and progression of diabetic kidney disease.
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