Subphenotypes in acute kidney injury: a narrative review.

Subphenotypes in acute kidney injury: a narrative review.
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DOI:
10.1186/s13054-022-04121-x
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发表时间:
2022-08-19
期刊:
Critical care (London, England)
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急性肾损伤(阿基)是一种常见的综合征,尤其是在危重病人中.目前阿基的诊断是基于肾功能的急性恶化,表现为肌酐升高和/或尿量减少。然而,这种综合征的定义包括各种不同的临床特征,不同的病理生理学,病因学和危险因素,以及最终非常不同的短期和长期结果。将所有阿基集中在一起可能隐藏特定于某些阿基人群的独特病理生理过程,发现这些阿基亚表型可能有助于开发针对独特病理生理过程的靶向治疗。在这篇综述中,我们讨论了阿基亚表型的概念,目前关于临床和生物标志物驱动的亚表型的知识,与阿基亚表型和其他ICU综合征的相互作用,以及潜在的未来和临床意义。
Acute kidney injury (AKI) is a frequently encountered syndrome especially among the critically ill. Current diagnosis of AKI is based on acute deterioration of kidney function, indicated by an increase in creatinine and/or reduced urine output. However, this syndromic definition encompasses a wide variety of distinct clinical features, varying pathophysiology, etiology and risk factors, and finally very different short- and long-term outcomes. Lumping all AKI together may conceal unique pathophysiologic processes specific to certain AKI populations, and discovering these AKI subphenotypes might help to develop targeted therapies tackling unique pathophysiological processes. In this review, we discuss the concept of AKI subphenotypes, current knowledge regarding both clinical and biomarker-driven subphenotypes, interplay with AKI subphenotypes and other ICU syndromes, and potential future and clinical implications.
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