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【文献翻译】Biological Variation of Plasma and Urinary Markers of Acute...

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发表于 2016-6-2 15:21:33 | 显示全部楼层 |阅读模式
Biological Variation of Plasma and Urinary Markers of Acute Kidney Injury in Patients with Chronic Kidney Disease

BACKGROUND: Identification of acute kidney injury (AKI) is predominantly based on changes in plasma creatinine concentration, an insensitive marker. Alternative biomarkers have been proposed. The reference change value (RCV), the point at which biomarker change can be inferred to have occurred with statistical certainty, provides an objective assessment of change in serial tests results in an individual.

METHODS: In 80 patients with chronic kidney disease, weekly measurements of blood and urinary biomarker concentrations were undertaken over 6 weeks. Variability was determined and compared before and after adjustment for urinary creatinine and across subgroups stratified by level of kidney function, proteinuria, and presence or absence of diabetes.

RESULTS: RCVs were determined for whole blood, plasma, and urinary neutrophil gelatinase-associated lipocalin (111%, 59%, and 693%, respectively), plasma cystatin C (14%), creatinine (17%), and urinary kidney injury molecule 1 (497%), tissue inhibitor of metalloproteinases 2 (454%), N-acetyl-β-D-glucosaminidase (361%), interleukin-18 (819%), albumin (430%), and α1-microglobulin (216%). Blood biomarkers exhibited lower variability than urinary biomarkers. Generally, adjusting urinary biomarker concentrations for creatinine reduced (P < 0.05) within-subject biological variability (CVI). For some markers, variation differed (P < 0.05) between subgroups.

CONCLUSIONS: These data can form a basis for application of these tests in clinical practice and research studies and are applicable across different levels of kidney function and proteinuria and in the presence or absence of diabetes. Most of the studied biomarkers have relatively high CVI (noise) but also have reported large concentration changes in response to renal insult (signal); thus progressive change should be detectable (high signal-to-noise ratio) when baseline data are available.

链接:http://www.clinchem.org/content/62/6/876.abstract

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发表于 2016-6-2 16:19:20 | 显示全部楼层
领了。。。。。。。

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发表于 2016-6-3 10:11:30 | 显示全部楼层
慢性肾病患者血浆和尿中急性肾损伤标志物的生物学变异

       背景:急性肾损伤(AKI)的鉴定主要是依据肌酐这一不敏感标记物的血浆浓度。其他替代的生物标志物已被提出。参考变化值(RCV,生物标志物变化可以推断有统计确定发生的范围),提供了一个个体串行测试结果变化的客观评价。
       方法:80例慢性肾脏病患者,每周测量血液和尿液中的生物标志物浓度,累计超过6周。确定标记物浓度变化。根据肾功能,蛋白尿,是否患有糖尿病进行亚组分层,并用尿肌酐水平变化进行校正,比较校正前后的标记物浓度的变化。
       结果:确定全血,血浆和尿液中性粒细胞明胶酶蛋白的RCV分别为111%,59%,和693%;血浆胱抑素C的RCV为14%;血浆肌酐的RCV为17%;尿肾损伤分子1的RCV为497%;尿基质金属蛋白酶组织抑制因子2的RCV为454%;尿n-乙酰-β-d-氨基葡萄糖苷酶的RCV为361%;尿白细胞介素的-18、白蛋白和α1球蛋白的RCV分别为819%、430%)和216%。与尿生物标志物相比,血液生物标志物具有较低的变异。总体上,用肌酐浓度减少(P < 0.05)对尿生物标记物进行校正可以减少试内生物变异(CVI)。对于某些标记,不同亚组的变异不同(P < 0.05)
       结论:这些数据可以为临床实践和研究中应用这些数据的奠定基础,并适用于不同的肾功能水平,蛋白尿,糖尿病的存在或不存在的情况。大多数研究的生物标志物具有较高的CVI(噪声),也有报道称根据肾损伤情况具有很大的浓度变化(信号);因此在基线数据可用的情况下,这些标记物的进展变化需要被检测(高信噪比)。

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 楼主| 发表于 2016-6-3 16:30:57 | 显示全部楼层
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