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首页> 外文期刊>Kidney international supplements. >Biomarkers in kidney fibrosis: Are they useful?
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Biomarkers in kidney fibrosis: Are they useful?

机译：肾纤维化中的生物标志物：它们有用吗？

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With the escalating cost of monitoring and follow-up required in the care of patients with chronic kidney disease (CKD), biomarkers are increasingly being investigated for their utility in predicting patients most at risk of decline in renal function in order to rationalize and target care. Putative biomarkers have also emerged as treatment targets, with the potential to develop novel therapeutics. However, biomarker studies in CKD are largely derived from single-sample collections in observational or nested case-control studies that are suboptimal in study design, analyses, and end points relevant to confirm the utility of specific biomarkers. It has been demonstrated that biomarker expression may be modified by declining kidney function. Hence, their value in predicting future kidney dysfunction is limited. Therefore, understanding the nature, mechanism of action, and how specific biomarkers interact with the CKD disease process is a crucial step in defining the potential for biomarkers to predict outcome, or alternatively, develop as a therapeutic target. Unlike conventional risk factors that, albeit partly, enable us to distinguish an individual at risk of cardiovascular disease, biomarkers in patients with CKD may not be required to be modifiable either directly or indirectly in the disease process or by therapy. Reproducibility and prospective validation remain major challenges for the burgeoning number of purported biomarkers in patients with CKD. It is highly likely a combination of conventional and novel biomarkers will be needed to accurately predict the risk of end-stage kidney disease. This review will focus on recently identified biomarkers and their utility in predicting progressive kidney fibrosis.
机译：随着慢性肾脏病（CKD）患者的治疗所需的监测和随访费用不断上升，越来越多地研究生物标志物在预测最有可能肾功能下降风险的患者中的作用，以便合理化和针对性治疗。推定的生物标志物也已成为治疗目标，具有开发新疗法的潜力。但是，CKD中的生物标志物研究主要来自观察性或巢式病例对照研究中的单样本收集，这些研究在研究设计，分析和终点方面均次优，无法确定特定生物标志物的用途。已经证明，可以通过降低肾功能来修饰生物标志物的表达。因此，它们在预测未来肾功能障碍中的价值是有限的。因此，了解其性质，作用机制以及特定生物标志物如何与CKD疾病过程相互作用是确定生物标志物预测结果或发展为治疗靶标潜力的关键步骤。与传统的危险因素（尽管可以部分使我们能够区分具有心血管疾病危险的个体）不同，CKD患者的生物标志物可能不需要在疾病过程中或通过治疗直接或间接地被修改。重现性和前瞻性验证仍然是CKD患者中据称数量众多的生物标志物的主要挑战。很有可能需要将常规生物标志物和新型生物标志物结合起来才能准确预测终末期肾脏疾病的风险。这篇综述将集中于最近发现的生物标志物及其在预测进行性肾纤维化中的效用。

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