Subclinical AKI is still AKI.
Subclinical AKI is still AKI.
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DOI：
10.1186/cc11240
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发表时间：
2012-06-21
期刊：
影响因子：
--
通讯作者：
Haase M
中科院分区：
文献类型：
--
作者：
Ronco C;Kellum JA;Haase M
近年来，急性肾综合征的概念已从急性肾衰竭转变为急性肾损伤（AKI）。 AKI 意味着受伤或损害，但不一定意味着功能障碍。人类肾脏具有重要的肾小球功能储备，只有当超过 50% 的肾脏质量受到损害时，功能障碍才会变得明显。最近的 AKI 分类甚至包括血清肌酐的轻微变化，承认这种情况与更糟糕的结果相关。然而，这仍然代表 AKI 的功能标准，并意味着肾小球滤过率的改变可能是该综合征时间过程中的晚期现象。如今，通过使用滤过功能丧失之前的肾小管损伤生物标志物来早期诊断 AKI 已成为可能。一些研究表明，新的生物标志物具有额外的价值，不仅因为它们可以更早地做出诊断，而且因为它们甚至可以在没有随后的功能障碍的情况下诊断出肾损伤。直到最近，没有肾小球功能丧失的肾小管损伤才被证明与较差的肾脏和整体结果相关。对于这种情况，引入了“亚临床”AKI 一词，挑战了传统观点，即只有当滤过功能丧失明显时，肾脏问题才具有临床相关性。 AKI 诊断的新领域可能包括功能标准和损伤标准。这可能会对 AKI 的流行病学、预防和管理产生影响。
The concept of acute kidney syndromes has shifted in recent years from acute renal failure to acute kidney injury (AKI). AKI implies injury or damage but not necessarily dysfunction. The human kidney has an important glomerular function reserve, and dysfunction becomes evident only when more than 50% of the renal mass is compromised. Recent AKI classifications include even slight changes in serum creatinine, acknowledging that this condition is associated with worse outcomes. This, however, still represents a functional criterion for AKI and implies a glomerular filtration rate alteration that may be a late phenomenon in the time course of the syndrome. An early diagnosis of AKI by using tubular damage biomarkers preceding filtration function loss is possible today. Some studies have shown evidence that there is an additional value of new biomarkers not only because they allow a diagnosis to be made earlier but also because they allow a kidney injury to be diagnosed even in the absence of subsequent dysfunction. Only recently, tubular damage without glomerular function loss was demonstrated to be associated with worse renal and overall outcomes. For this condition, the term 'subclinical' AKI has been introduced, challenging the traditional view that a kidney problem is clinically relevant, only when a loss of filtration function becomes apparent. A new domain of AKI diagnosis could then include functional criteria and damage criteria. This may have an impact on the epidemiology, prevention, and management of AKI.
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影响因子：
39.2
作者：
Nickolas, Thomas L.;O'Rourke, Matthew J.;Barasch, Jonathan
通讯作者：
Barasch, Jonathan
影响因子：
24
作者：
Nickolas, Thomas L.;Schmidt-Ott, Kai M.;Canetta, Pietro;Forster, Catherine;Singer, Eugenia;Sise, Meghan;Elger, Antje;Maarouf, Omar;Sola-Del Valle, David Antonio;O'Rourke, Matthew;Sherman, Evan;Lee, Peter;Geara, Abdallah;Imus, Philip;Guddati, Achuta;Polland, Allison;Rahman, Wasiq;Elitok, Saban;Malik, Nasir;Giglio, James;El-Sayegh, Suzanne;Devarajan, Prasad;Hebbar, Sudarshan;Saggi, Subodh J.;Hahn, Barry;Kettritz, Ralph;Luft, Friedrich C.;Barasch, Jonathan
通讯作者：
Barasch, Jonathan
影响因子：
13.2
作者：
Haase, Michael;Bellomo, Rinaldo;Haase-Fielitz, Anja
通讯作者：
Haase-Fielitz, Anja
影响因子：
41.5
作者：
Murugan, Raghavan;Kellum, John A.
通讯作者：
Kellum, John A.
DOI：
10.1186/cc2872
发表时间：
2004-08
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bellomo R;Ronco C;Kellum JA;Mehta RL;Palevsky P;Acute Dialysis Quality Initiative workgroup
通讯作者：
Acute Dialysis Quality Initiative workgroup