Han Ouyang, Rui Ma, Xiaobing Yang, Chunbo Chen, Xin Xu, Jianwei Tian, Jun Liu, Yan Zha, Huafeng Liu, Tiecheng Yang, Fan Fan Hou
{"title":"尿液细胞角蛋白 20 作为急性失代偿性心力衰竭和 AKI 患者 AKI-CKD 转化的生物标记物","authors":"Han Ouyang, Rui Ma, Xiaobing Yang, Chunbo Chen, Xin Xu, Jianwei Tian, Jun Liu, Yan Zha, Huafeng Liu, Tiecheng Yang, Fan Fan Hou","doi":"10.1681/ASN.0000000518","DOIUrl":null,"url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Urinary Cytokeratin 20 as a Biomarker for AKI-CKD Transition among Patients with Acute Decompensated Heart Failure and Acute Kidney Injury.\",\"authors\":\"Han Ouyang, Rui Ma, Xiaobing Yang, Chunbo Chen, Xin Xu, Jianwei Tian, Jun Liu, Yan Zha, Huafeng Liu, Tiecheng Yang, Fan Fan Hou\",\"doi\":\"10.1681/ASN.0000000518\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\",\"PeriodicalId\":17217,\"journal\":{\"name\":\"Journal of The American Society of Nephrology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":10.3000,\"publicationDate\":\"2024-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of The American Society of Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1681/ASN.0000000518\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of The American Society of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1681/ASN.0000000518","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:在急性失代偿性心力衰竭和 AKI 的治疗过程中,预测 AKI-CKD 转化风险仍是一项重大挑战。尿液细胞角蛋白 20(CK20)是一种反映急性肾小管损伤组织学严重程度的新型生物标记物,本研究探讨了尿液细胞角蛋白 20 在识别 AKI-CKD 进展风险患者方面的临床实用性:这项前瞻性队列研究包括5个中心的279名急性失代偿性心衰和AKI连续住院患者组成的测试集和一个外部中心的206名类似患者组成的验证集。在确诊 AKI 时测定了尿液 CK20 和七种已报道的肾小管损伤生物标志物。主要结果是 AKI 后 90 天内 AKI-CKD 转化或 90 天内全因死亡的复合结果。次要结果是 AKI 90 天后 AKI-CKD 进展:在测试组中,115 例(41%)患者达到了主要终点。尿液中 CK20 的浓度在确诊急性肾功能缺损当天达到峰值,并在急性肾功能缺损后 14 天内持续升高。经多变量调整后,尿 CK20 的最高三分位数与主要结局风险高 21 倍和次要结局风险高 29 倍相关。在预测主要结局和次要结局方面,诊断出 AKI 时的尿 CK20 的接受者操作特征曲线下面积 (AUC) 分别为 0.82(95% 置信区间 [CI],0.77-0.87)和 0.81(95% 置信区间 [CI],0.75-0.87),优于其他已报道的反映急性肾小管损伤和 CKD 风险的生物标志物。在临床变量中加入尿 CK20 提高了预测主要结果的能力,其 AUC 为 0.90(95% CI,0.85-0.94),并在很大程度上提高了风险再分类的能力。尿液 CK20 预测 AKI-CKD 转归的能力在验证组中得到了进一步证实:尿 CK20 提高了对急性失代偿性心力衰竭合并 AKI 患者从 AKI 向 CKD 过渡风险的预测能力。
期刊介绍:
The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews.
Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication.
JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.