CSCIED

期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据:

Open Access Article

International Journal of Clinical Research. 2025; 9: (4) ; 24-28 ; DOI: 10.12208/j.ijcr.20250177.

Research progress on detection indicators of early renal injury in liver cirrhosis
肝硬化早期肾损伤检测指标的研究进展

作者: 董程萱, 杨婧 *, 王莎, 刘清清, 胡绍山

昆明医科大学第二附属医院 云南昆明

*通讯作者: 杨婧,单位:昆明医科大学第二附属医院 云南昆明;

发布时间: 2025-04-28 总浏览量: 20

摘要

肝硬化病程中会伴随着不同程度的肾损伤,肾损伤不断加重则可能进展为急性肾损伤甚至肝肾综合征,患者预后极差,病死率极高。因此对肝硬化患者肾损伤情况进行早期监测具有十分重要的意义。目前临床上常用的肾功能检测指标对肾损伤的早期诊断价值较低,我们需要更敏感的指标判断肝硬化患者是否存在肾损伤以及反映肾损伤程度。本文就目前国内外认可度较高的肾损伤早期检测指标的研究进展进行综述。

关键词: 综述;肝硬化;肾损伤;诊断;预测

Abstract

The course of cirrhosis is accompanied by varying degrees of kidney injury, which may progress to acute kidney injury or even hepatorenal syndrome if the kidney injury worsens. The prognosis of patients is very poor, and the fatality rate is very high. Therefore, early monitoring of kidney damage in patients with cirrhosis is of great significance. At present, the commonly used renal function detection indicators are of low value in the early diagnosis of kidney injury. We need more sensitive indicators to determine whether patients with cirrhosis have kidney injury and reflect the degree of kidney injury. We need more sensitive indicators to determine whether patients with cirrhosis have kidney injury and the degree of kidney injury. This article reviews the research progress of early detection indexes of kidney injury which are well recognized at home and abroad.

Key words: Summary; Liver cirrhosis; Kidney injury; Diagnosis; Forecast

参考文献 References

[1] Lum EL, Homkrailas P, Bunnapradist S. Evaluation of Renal Disease in Patients With Cirrhosis[J]. J Clin Gastroenterol. 2020,54(4):314-21.

[2] Nadim M K, Garcia-Tsao G. Acute kidney injury in patients with cirrhosis[J]. New England Journal of Medicine, 2023, 388(8): 733-745.

[3] 欧进军, 韩焕钦, 郑伟强. 肝硬化并发急性肾损伤早期诊断生物标志物研究进展[J]. 肝脏, 2018, 23(3): 260-262.

[4] 刘清清,杨婧,胡绍山,等.肝硬化肾损伤的发病机制与诊治进展[J].临床肝胆病杂志,2023,39(06):1461-1467.

[5] Cai, T, Karlaftis, V, Hearps, S, et al. Reference intervals for serum cystatin C in neonates and children 30 days to 18 years old. PEDIATR NEPHROL. 2020; 35 (10): 1959-1966.

[6] Murty, MS, Sharma, UK, Pandey, VB, et al. Serum cystatin C as a marker of renal function in detection of early acute kidney injury. INDIAN J NEPHROL. 2013; 23 (3): 180-3. 

[7] 路丽芳,冯国和.肝硬化并发肾损伤早期检测指标的研究进展[J].临床肝胆病杂志,2016,32(09):1797-1800.

[8] Mindikoglu A L, Dowling T C, Weir M R, et al. Performance of chronic kidney disease epidemiology collaboration creatinine‐cystatin C equation for estimating kidney function in cirrhosis[J]. Hepatology, 2014, 59(4): 1532-1542.

[9] 高攀,朱祖安.胱抑素C对失代偿期肝硬化患者并发肝肾综合征的预测价值[J].胃肠病学和肝病学杂志,2019,28 (01): 101-104.

[10] Belcher, JM, Sanyal, AJ, Garcia-Tsao, G, et al. Early trends in cystatin C and outcomes in patients with cirrhosis and acute kidney injury. INT J NEPHROL. 2014; 2014 708585. 

[11] Rajakumar, A, Appuswamy, E, Kaliamoorthy, I, et al. Renal Dysfunction in Cirrhosis: Critical Care Management. INDIAN J CRIT CARE M. 2021; 25 (2): 207-214.

[12] 李乐维,齐莹莹,胡亚会.尿β2-MG、NAG及RBP联合检验在临床判定乙肝肝硬化患者发生早期肾损伤中应用价值分析[J].罕少疾病杂志,2024,31(09):80-82.

[13] 叶亮,李运泽,蒙毅军,等.尿微量白蛋白联合胱抑素C、α1微球蛋白、β2微球蛋白检测在早期肝肾综合征的诊断价值[J].中国中西医结合消化杂志,2021,29(12):894-899.

[14] 张会芬,杨宏秀,刘丽,等.血清中性粒细胞明胶酶相关脂质运载蛋白、胱抑素C及尿白蛋白肌酐比值、N-乙酰-β-D-氨基葡萄糖苷酶检测在早期糖尿病肾脏疾病中的应用价值[J].中国糖尿病杂志,2018,26(04):309-315.

[15] 张静怡,唐映梅,杨娴,等.尿α1-微球蛋白及N-乙酰-β-D-氨基葡萄糖苷酶/尿肌酐在慢性HBV感染相关肝病患者早期肾损伤中的检测价值[J].临床肝胆病杂志,2022, 38(02): 322-327.

[16] Kim, TH, Lee, HA, Seo, YS, et al. Assessment and prediction of acute kidney injury in patients with decompensated cirrhosis with serum cystatin C and urine N-acetyl-β-D-glucosaminidase.J GASTROEN HEPATOL. 2018;34(1):234-240.

[17] Xia, Y, Li, J, Li, S, et al. Clinical value of urinary retinol-binding protein in ascites due to cirrhosis. EXP THER MED. 2017; 14 (5): 5228-5234. 

[18] 王晶晶,李春涛,周卫真.失代偿期乙型肝炎肝硬化患者尿液视黄醇结合蛋白水平及其临床意义探讨[J].实用肝脏病杂志,2020,23(01):74-77.

[19] Paragas, N, Qiu, A, Hollmen, M, et al. NGAL-Siderocalin in kidney disease. BIOCHIM BIOPHYS ACTA. 2012; 1823 (9): 1451-8. 

[20] 张佳思.血NGAL、胱抑素-C和尿酸在糖尿病肾脏疾病早期诊断中的价值[D].大连医科大学,2021.

[21] Davis, J, Rossi, G, Miller, DW, et al. Ability of different assay platforms to measure renal biomarker concentrations during ischaemia-reperfusion acute kidney injury in dogs. RES VET SCI. 2020; 135 547-554. 

[22] Holzscheiter, L, Beck, C, Rutz, S, et al. NGAL, L-FABP, and KIM-1 in comparison to established markers of renal dysfunction. CLIN CHEM LAB MED. 2014; 52 (4): 537-46. 

[23] Cai, J, Jiao, X, Luo, W, et al. Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury. RENAL FAILURE. 2019; 41 (1): 80-87.

[24] 张谊雯,刘剑华.血液中肾损伤分子-1(KIM-1)和血清肌酐(SCr)对AKI的生物标志物作用[J].基因组学与应用生物学,2020,39(03):1289-1294.

[25] Yap, DY, Seto, WK, Fung, J, et al. Serum and urinary biomarkers that predict hepatorenal syndrome in patients with advanced cirrhosis. DIGEST LIVER DIS. 2016; 49 (2): 202-206. 

[26] 徐伟伟,田鹏辉,刘芳芳.白介素-18在脓毒血症急性肾损伤患者血清中的表达水平及临床意义[J].河南医学研究, 2020, 29(33):6296-6298.

[27] Sirota, JC, Walcher, A, Faubel, S, et al. Urine IL-18, NGAL, IL-8 and serum IL-8 are biomarkers of acute kidney injury following liver transplantation. BMC Nephrol. 2013; 14 BMC Nephrol. 

[28] 曹丽娜,万远太.肝肾综合征早期生物学标志物的研究进展[J].医学综述,2020,26(12):2435-2439+2445.

[29] Kamijo-Ikemori, A, Sugaya, T, Ichikawa, D, et al. Urinary liver type fatty acid binding protein in diabetic nephropathy. CLIN CHIM ACTA. 2013; 424 104-8. 

[30] Kashani, K, Al-Khafaji, A, Ardiles, T, et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. CRIT CARE. 2013; 17 (1): R25. 

[31] 李明,陈入溧,吴振平,等.尿液中IGFBP7和TIMP-2联合检测对HBV相关慢加急性肝衰竭致急性肾损伤的预测价值[J].临床肝胆病杂志,2019,35(07):1560-1564.

引用本文

董程萱, 杨婧, 王莎, 刘清清, 胡绍山, 肝硬化早期肾损伤检测指标的研究进展[J]. 国际临床研究杂志, 2025; 9: (4) : 24-28.