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首页> 外文期刊>Cardiology in review >Novel Biomarkers of Acute Kidney Injury After Contrast Coronary Angiography
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Novel Biomarkers of Acute Kidney Injury After Contrast Coronary Angiography

机译：对比冠状动脉造影后急性肾脏损伤的新型生物标志物

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Acute kidney injury (AKI), defined as a rise in serum creatinine of greater than 25% from baseline measured at 48 hours after renal insult, may follow iodinated contrast coronary angiography. Termed contrast-induced nephropathy, it can result in considerable morbidity and mortality. Measurement of serum creatinine as a functional biomarker of glomerular filtration rate is widely used for detection of AKI, but it lacks sensitivity for the early diagnosis of AKI (typically rising 24 hours after functional loss) and, as a solely functional marker of glomerular filtration rate, is unable to differentiate among the various causes of AKI. These intrinsic limitations to creatinine measurement and the recognition that improved clinical outcomes are linked to a more timely diagnosis of AKI, has led investigators to search for novel biomarkers of "early" kidney injury. Several studies have investigated the utility of renal injury biomarkers in a variety of clinical settings including angiography/percutaneous coronary intervention, coronary artery bypass graft surgery, sepsis in intensive care patients, and pediatric cardiac surgery. In this article, we discuss the use of iodinated contrast for coronary procedures and the risk factors for contrast-induced nephropathy, followed by a review the potential diagnostic utility of several novel biomarkers of early AKI in the clinical settings of coronary angiography/percutaneous coronary intervention. In particular, we discuss neutrophil gelatinase associated lipocalin in depth. If validated, such biomarkers would facilitate earlier AKI diagnosis and improve clinical outcomes.
机译：急性肾损伤（AKI），定义为在肾损害后48小时测得的血清肌酐比基线增加了25％以上，可在碘造影造影后进行。称为造影剂诱发的肾病，它可以导致相当高的发病率和死亡率。血清肌酐作为肾小球滤过率功能性生物标志物的测定已广泛用于AKI的检测，但缺乏对AKI的早期诊断（通常在功能丧失后24小时升高）的敏感性，并且作为肾小球滤过率的唯一功能性标志物，无法区分AKI的各种原因。肌酐测量的这些固有局限性以及人们认识到临床结局的改善与AKI的更及时诊断有关，这促使研究人员寻找“早期”肾脏损伤的新型生物标志物。几项研究调查了肾脏损伤生物标记物在各种临床环境中的效用，包括血管造影/经皮冠状动脉介入治疗，冠状动脉搭桥术，重症监护患者的败血症和小儿心脏手术。在本文中，我们讨论了碘造影剂在冠状动脉手术中的使用以及造影剂引起的肾病的危险因素，然后回顾了早期AKI的几种新型生物标志物在冠状动脉造影/经皮冠状动脉介入治疗的临床环境中的潜在诊断实用性。特别地，我们深入讨论中性粒细胞明胶酶相关的脂蛋白。如果经过验证，这些生物标记物将有助于早期AKI诊断并改善临床结果。

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