题名

急性腎損傷在肝硬化病患上的診斷、治療以及未來發展

DOI

10.6666/ClinMed.2017.80.6.133

作者

呂學聖；陳炳憲

关键词

急性腎損傷(acute kidney injury) ； 肝硬化(liver cirrhosis) ； 急性腎小管壞死(acute tubular necrosis) ； 肝腎症候群(hepatorenal syndrome) ； 尿液生物指標(urine biomarkers)

期刊名称

臨床醫學月刊

卷期/出版年月

80卷6期（2017 / 12 / 29）

页次

735 - 740

内容语文

繁體中文
中文摘要

由於近年來急性腎損傷的定義推陳出新，International club of ascites於2012年開始制定新的急性腎損傷在肝硬化病患上的定義並於2015年發表，並根據新的定義制訂了新治療建議，但是由於目前之診斷標準無法區分肝腎症候群型急性腎損傷(hepatorenal syndrome type of acute kidneyinjury)跟急性腎小管壞死(acute tubular necrosis)，所以目前有許多針對腎小管壞死相關之尿液生物指標(urine biomarkers)正在發展，包括(1) neutrophil gelatinase-associated lipocalin (NGAL)；(2) interleukin 18 (IL-18)；(3)kidney injury molecule 1 (KIM-1)；(4) livertype fatty acid-bindingprotein (L-FABP)，但是各個指標皆有其限制，所以還需更多研究來證實。
主题分类 醫藥衛生 > 基礎醫學
醫藥衛生 > 社會醫學
参考文献
  1. Angeli, P(2015).Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites.Gut,64,531-537.
  2. Angeli, P,Gatta, A,Caregaro, L(1990).Tubular site of renal sodium retention in ascitic liver cirrhosis evaluated by lithium clearance.Eur J Clin Invest,20,111-117.
  3. Ariza, X,Sola, E,Elia, C(2015).Analysis of a urinary biomarker panel for clinical outcomes assessment in cirrhosis.PLoS One,10,e0128145.
  4. Arroyo, V,Gines, P,Gerbes, AL(1996).Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis.Hepatology,23,164-176.
  5. Bataller, R,Ginès, P,Guevara, M(1997).Hepatorenal syndrome.Semin Liver Dis,17,233-247.
  6. Belcher, JM,Garcia-Tsao, G,Sanyal, AJ(2014).Urinary biomarkers and progression of AKI in patients with cirrhosis.Clin J Am Soc Nephrol,9,1857-1867.
  7. Belcher, JM,Sanyal, AJ,Peixoto, AJ(2014).Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury.Hepatology,60,622-632.
  8. Caregaro, L,Menon, F,Angeli, P(1994).Limitations of serum creatinine level and creatinine clearance as filtration markers in cirrhosis.Arch Intern Med,154,201-205.
  9. Doi, K,Maeda-Mamiya, R(2010).Urinary L-type fatty acid-binding protein as a new biomarker of sepsis complicated with acute kidney injury.Crit Care Med,38,2037-2042.
  10. Fagundes, C,Pepin, MN,Guevara, M(2012).Urinary neutrophil gelatinase-associated lipocalin as biomarker in The differential diagnosis of impairment of kidney function in cirrhosis.J Hepatol,57,267-273.
  11. Francoz, C,Nadim, MK,Durand, F(2016).Kidney biomarkers in cirrhosis.J Hepatol,65,809-824.
  12. Furuhashi, M,Hotamisligil, GS(2008).Fatty acid-binding proteins: role in metabolic diseases and potential as drug targets.Nat Rev Drug Discov,7,489-503.
  13. Garcia-Tsao, G,Parikh, CR,Viola, A(2008).Acute kidney injury in cirrhosis.Hepatology,48,2064-2077.
  14. Ichimura, T,Bonventre, JV,Bailly, V(1998).Kidney injury molecule-1 (KIM-1), a putative epithelial cell adhesion molecule containing a novel immunoglobulin domain, is up-regulated in renal cells after injury.J Biol Chem,273,4135-4142.
  15. Kamijo-Ikemori, A,Sugaya, T,Matsui, K(2011).Roles of human liver type fatty acid binding protein in kidney disease clarified using hL-FABP chromosomal transgenic mice.Nephrology,16,539-544.
  16. Liu, Y,Guo, W,Zhang, J(2013).Urinary interleukin 18 for detection of acute kidney injury: a meta-analysis.Am J Kidney Dis,62,1058-1067.
  17. Mishra, J,Ma, Q,Prada, A(2003).Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury.J Am Soc Nephrol,14,2534-2543.
  18. Nishida, M,Kawakatsu, H,Okumura, Y(2010).Serum and urinary neutrophil gelatinase-associated lipocalin levels in children with chronic renal diseases.Pediatr Int,52,563-568.
  19. Parikh, CR,Devarajan, P(2008).New biomarkers of acute kidney injury.Crit Care Med,36,S159-S165.
  20. Salerno, F,Gerbes, A,Gines, P(2007).Diagnosis, prevention and treatment of the hepatorenal syndrome in cirrhosis: a consensus workshop of the International Ascites Club.Gut,56,1310-1318.
  21. Sherman, DS,Fish, DN,Teitelbaum, I(2003).Assessing renal function in cirrhotic patients: problems and pitfalls.Am J Kidney Dis,41,269-278.
  22. Spencer, K(1986).Analytical reviews in clinical biochemistry: the estimation of creatinine.Ann Clin Biochem,23,1-25.
  23. Wu, H,Craft, ML,Wang, P(2008).IL-18 contributes to renal damage after ischemia-reperfusion.J Am Soc Nephrol,19,2331-2341.
  24. Yamamoto, T,Noiri, E,Ono, Y(2007).Renal L-type fatty acid-binding protein in acute ischemic injury.J Am Soc Nephrol,18,2894-2902.
print cancel