修改的furosemide响应指数和AKI进展和预后的生物标志物:一项前性观察研究
Ying Su1, Wen-Jun Liu1, Yu-Feng Zhao2
1Cardiac Intensive Care Center, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Annals of intensive care
|October 8, 2024
概括
修改后的罗塞米德响应指数 (mFRI) 有效地预测心脏手术患者急性损伤 (AKI) 的进展和不良结果. 这种新型生物标志物表现出与现有的脏生物标志物相当或优于其性能.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 生物标志物发现发现
背景情况:
- 急性损伤 (AKI) 是心脏手术后的一个常见并发症.
- 早期识别AKI进展和预后对于患者的治疗结果至关重要.
- 需要新的生物标志物来改善对脏不良事件的预测.
研究的目的:
- 为了评估修改后的罗塞米德响应指数 (mFRI) 与已确定的脏生物标志物的预测性表现.
- 评估mFRI在预测轻度至中度AKI患者的AKI进展和不良结局方面的能力.
- 确定将mFRI与其他生物标志物的结合是否提高了预测准确性.
主要方法:
- 对1013名心脏手术后轻度至中度AKI患者进行前性研究.
- 在AKI诊断时测量mFRI,各种脏生物标志物 (sNGAL,uNGAL,cystatin C,uNAG,白蛋白与肌素的比率) 和细胞因子.
- 对mFRI对AKI进展,3期AKI和复合结果 (死亡率或RRT) 的区分能力的分析.
主要成果:
- mFRI对AKI进展 (AUC0.80),进展到第三阶段 (AUC0.87) 和复合结局 (AUC0.85) 的预测性表现强.
- 与其他脏生物标志物和细胞因子相比,mFRI显示出非劣质或优异的预测能力.
- 将mFRI与尿路生物标志物 (uNAG或uNGAL) 结合起来,显著改善了对不良结局的预测.
结论:
- mFRI是一种快速,具有成本效益和可访问的生物标志物,用于预测AKI的进展和预后.
- 在这个患者队列中,mFRI表现出比传统脏生物标志物更优越或同等的预测能力.
- 包括mFRI在内的组合生物标志物为不良脏结果提供了增强的预测能力.
相关概念视频
Acute Kidney Injury IV: Diagnostic Studies and Prevention
2
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
2
Acute Kidney Injury I: Introduction
2
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
2
Acute Kidney Injury V: Interprofessional Care
2
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
2
Factors Affecting Renal Clearance: Renal Impairment
59
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
59
Renal Failure: Dose Adjustments
68
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
68
Acute Kidney Injury III: Clinical Manifestations
2
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
2


