Challenges facing early detection of acute kidney injury in the critically ill

作     者：John W Pickering Zoltán H Endre John Pickering 

作者机构：Christchurch Kidney Research GroupDepartment of MedicineUniversity of OtagoChristchurch 8140New Zealand Department of NephrologyPrince of Wales Clinical SchoolUniversity of New South WalesSydney NSW 2052Australia Christchurch Kidney Research GroupDepartment of MedicineUniversity of OtagoPO Box 4345Christchurch 8140New Zealand 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2012年第1卷第3期

页      面：61-66页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Supported by Grants from the Australian and New Zealand Society of Nephrology Infrastructure and Enabling and the Marsden Fund Council from Government funding administered by the Royal Society of New Zealand 

主　　题：Acute kidney injury Acute renal failure Biomarkers Creatinine 

摘      要：Recent advances in the detection of acute kidney injury(AKI) afford the possibility of early intervention. Proteomics and genomics have identified many markers of tubular cell injury, some of which are manifest in the urine. One trial has used novel injury biomarkers to recruit patients to an intervention prior to an elevation in plasma creatinine. This trial and other recent studies have shown that the use of biomarkers of injury will depend on the time the patient presents following insult to the kidney, the likely cause of that insult, and the pre-injury renal function of that patient. The definition of AKI is likely to change in the near future to include a measure of injury. We anticipate novel therapies becoming available following successful trials that utilize the methodology of early intervention following an elevated injury biomarker.