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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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在ASSESS-AKI研究中发现,尿表皮生长因子与重大脏不良事件的风险降低有关
Steven Menez1, Yumeng Wen1, Leyuan Xu2
1Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Kidney international
|August 31, 2023
概括
住院后尿表皮生长因子 (EGF) 水平可以预测病风险. 排泄后尿液EGF/肌素 (Cr) 的较高水平与较低的重大脏不良事件 (MAKE) 风险有关,有助于患者的预后.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物标志物发现发现
- 翻译医学是一种翻译医学.
背景情况:
- 慢性病 (CKD) 对健康造成重大负担,需要改善住院患者的预后工具.
- 急性损伤 (AKI) 幸存者患有慢性病的风险增加,强调了早期检测和风险分层的必要性.
- 表皮生长因子 (EGF) 是管状功能和脏健康的潜在生物标志物.
研究的目的:
- 在住院患者中,研究尿液EGF/肌素 (uEGF/Cr) 水平与重大脏不良事件 (MAKE) 之间的关联.
- 为了确定uEGF/Cr在不同的时间点 (住院,出院后3个月) 和其中的变化是否预测CKD发病率,进展或功能衰竭.
- 使用小鼠模型探索EGF表达在损伤和修复机制中的作用.
主要方法:
- 针对1509名住院参与者的前性观察队列研究 (ASSESS-AKI).
- 在住院和出院3个月后测量尿液EGF/肌素 (uEGF/Cr).
- 考克斯比例危险回归分析uEGF/Cr与MAKE在4.3年的随访期间的关联.
- 用小鼠模型进行损伤和修复的机制研究.
主要成果:
- 在出院3个月后,较高的uEGF/Cr水平与MAKE风险显著降低有关 (aHR为0.46).
- 从住院到出院3个月后,uEGF/Cr的较大增加也与MAKE的风险较低相关 (aHR为0.52).
- 一个在3个月内结合uEGF/Cr的预测模型显示MAKE的中度歧视 (AUC 0.73) 和功能衰竭的强烈歧视 (AUC 0.96).
- 与渐进性缩相比,小鼠模型在适应性脏修复中显示了EGF恢复的加速.
结论:
- 尿液EGF/Cr作为远端管道健康的一个有价值的生物标志物.
- 升高的uEGF/Cr水平和出院后的增加趋势独立地与住院患者严重脏不良事件的风险降低有关.
- 这种生物标志物有望改善预后,并指导住院后对病风险的临床管理.
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