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Crit Care:急性肾损伤的新预测因素:uKIM-1

2016-09-10 Seven L 译 MedSci原创

背景:急性肾损伤(AKI)是常见的临床综合征,预后差。肾功能不全的传统标志物在预防和及时评估肾损伤严重性、以及治疗药物管理方面,具有不敏感性和非特异性。尿肾损伤分子-1(uKIM-1)是肾小管上皮细胞损伤的标志物。不同uKIM-1水平与不同程度的肾损伤相关。本研究旨在探究,uKIM-1水平能否评估AKI患者的肾功能预后。 方法:对258例患者进行了筛选,总共纳入了201例患者,随访过程中丢失

背景:急性肾损伤(AKI)是常见的临床综合征,预后差。肾功能不全的传统标志物在预防和及时评估肾损伤严重性、以及治疗药物管理方面,具有不敏感性和非特异性。尿肾损伤分子-1(uKIM-1)是肾小管上皮细胞损伤的标志物。不同uKIM-1水平与不同程度的肾损伤相关。本研究旨在探究,uKIM-1水平能否评估AKI患者的肾功能预后。

方法:对258例患者进行了筛选,总共纳入了201例患者,随访过程中丢失了17名患者;因此一共184例患者进入了研究分析。根据患者的短期(48小时)肾功能恢复情况,将其分为瞬时AKI组和肾AKI组。在定期随访的1年时间内,观察了患者肾功能的变化,对影响肾脏预后的危险因素进行了分析。

结果:肾AKI组与瞬时AKI组相比,uKIM-1水平更高。利用uKIM-1诊断肾AKI的ROC-AUC为0.691,其敏感性和特异性分别为66.3%和64.7%。肾功能恶化组与肾功能稳定组相比,uKIM-1水平更高。因此,uKIM-1水平是肾功能预后不良的预测因素。ROC曲线分析表明,基于uKIM-1预测肾AKI和AKI患者肾功能进展的AUC分别为0.680和0.703;敏感性分别为78.6%和78.4%;特异性分别为57.9%和60.8%。AKI患者uKIM-1 > 2.37 ng/mg与不良肾脏预后呈正相关。

结论:uKIM-1水平能敏感地预测AKI患者的肾功能预后,并有可能作为肾功能预后不良的早期筛查指标。

原始出处:

Yuanyuan Xie.et al.High urinary excretion of kidney injury molecule-1 predicts adverse outcomes in acute kidney injury: a case control study.Critical Care.Published: 10 September 2016

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2016-09-20 Jiangyh0406

    很有用,学习了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=131115, encodeId=aefe13111548, content=很有用,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76f6105517, createdName=Jiangyh0406, createdTime=Tue Sep 20 00:09:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126555, encodeId=9b31126555a0, content=学习了,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Wed Sep 14 11:29:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264228, encodeId=068e126422885, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Mon Sep 12 07:30:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397060, encodeId=18e7139e060b2, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Mon Sep 12 07:30:00 CST 2016, time=2016-09-12, status=1, ipAttribution=)]
    2016-09-14 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!!

    0

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