Nace Ogorevc, Peter Slak, Stevan Nikšić, Gregor Novljan, Petja Fister, Domen Plut
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引用次数: 0
摘要
急性肾损伤(AKI)是指肾功能受损,肾小球滤过率下降,导致容量、电解质和酸碱平衡失调的一种急性病症。AKI 可危及生命,也可导致慢性肾病。在病程早期诊断 AKI 或预测其发展非常重要,因为这会影响治疗决策、治疗效果,进而影响预后。在临床实践中,血清肌酐浓度升高仍然是诊断 AKI 最常见的实验室指标。然而,由于肌酐水平的升高具有滞后性,因此对早期诊断往往不敏感也不准确。肾小管损伤的新型生物标志物和肾心绞痛指数有望更早、更准确地预测 AKI。对比增强超声波造影术(CEUS)和超微血管造影术(UMA)是可以量化肾脏微灌注的放射学方法,或许可以预测 AKI 的发生。这两种方法尚未被用于量化有发生 AKI 风险因素的儿童的肾脏灌注。还需要进一步研究,将这些声像图技术与肾心绞痛指数和新出现的肾损伤生物标志物进行比较,以预测儿童和成人的急性肾损伤 (AKI)。
Contrast-Enhanced Ultrasound (CEUS) and Ultra-Microangiography (UMA) in Critically Ill Children with Acute Kidney Injury.
Acute kidney injury (AKI) is an acute condition of impaired kidney function with decreased glomerular filtration rate, which results in dysregulation in volume, electrolyte, and acid-base equilibrium. AKI can be a life-threatening condition and can also lead to chronic kidney disease. It is important to diagnose AKI early in the course of the disease or to predict its development, as this can influence therapeutic decisions, outcome, and, consequently, the prognosis. In clinical practice, an elevated serum creatinine concentration remains the most common laboratory indicator for diagnosing AKI. However, due to the delay in its rise, creatinine levels are often insensitive and inaccurate for early diagnosis. Novel biomarkers of kidney tubular injury and the renal angina index have shown promise in predicting AKI earlier and more accurately. Contrast-enhanced ultrasonography (CEUS) and ultra-microangiography (UMA) are radiological methods that can quantify renal microperfusion and may be able to predict the development of AKI. They have not yet been used for quantifying renal perfusion in children with risk factors for developing AKI. Further research is needed to compare these sonographic techniques with the renal angina index and emerging kidney injury biomarkers for predicting acute kidney injury (AKI) in both children and adults.
期刊介绍:
Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries.
The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.