摘要
背景:在过去的几十年里,由于新生儿护理的进步,早产儿的存活率不断提高。这一群体的生理学仍在研究中,一旦不完整的器官发生涉及到目前临床知识尚未明确的功能特殊性。未成熟的肾脏尤其容易受到具有潜在长期影响的急性损伤。目前急性肾损伤的诊断参数在早产儿中是有限的。常用的血清肌酐蛋白是预测早期病变的较差的生物标志物,因为它易受多种因素的影响,包括肌肉质量和胎龄。 目的:探讨新生儿肾脏发生、肾功能和急性肾损伤的相关证据,以及肾功能生物标志物的研究及其在早产儿诊断、随访和预后方面的潜在应用。 结果:早产儿达到足月胎龄时肾元数量减少,肾元质量下降。因此,肾小球滤过率和小管功能受损,并与胎龄成正比。尽管急性肾损伤在儿科人群中发病率很高,但由于缺乏适当的、合理的、非侵入性的生物标志物,急性肾损伤仍未得到充分诊断和良好的治疗。虽然胱抑素C、NGAL和KIM-1是很有前途的尿标记物,但目前的文献仍不一致。 结论:正确识别和规范敏感、特异的尿生物标志物,以便更好地评估早产儿肾功能,需要进一步研究。
关键词: 早产新生儿,肾功能,尿生物标志物,肾发生,急性肾损伤,低胎龄。
Current Medicinal Chemistry
Title:Nephrogenesis, Renal Function, and Biomarkers in Preterm Newborns
Volume: 29 Issue: 23
关键词: 早产新生儿,肾功能,尿生物标志物,肾发生,急性肾损伤,低胎龄。
摘要:
Background: The survival of premature newborns increased in the last decades due to advances in neonatal care. The physiology of this group is still under investigation, once the incomplete organogenesis entails functional particularities that are not yet clarified by current clinical knowledge. The immature kidneys are especially susceptible to acute injury with potential long-term impacts. Current diagnostic parameters of acute kidney injury are limited among the preterm population. The commonly used serum creatinine protein constitutes a poor biomarker to predict early lesions as it is susceptible to several factors, including muscle mass and gestational age.
Objective: The present review explores the evidence on nephrogenesis, renal function, and acute kidney injury in neonatology, as well as studies on renal function biomarkers and their potential application for diagnosis, follow-up, and prognosis in preterm newborns.
Results: Premature newborns reach full-term gestational age with reduced number and quality of nephrons. Consequently, the glomerular filtration rate and tubular function become impaired and are proportional to the gestational age. Despite having a high incidence among the pediatric population, acute kidney injury is still underdiagnosed and poorly managed due to the absence of proper, sensible, and non-invasive biomarkers. Although cystatin C, NGAL, and KIM-1, are promising urinary markers, current literature remains inconsistent.
Conclusion: Further research is needed to properly identify and standardize sensible and specific urinary biomarkers to better assess kidney function in preterm newborns.
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Cite this article as:
Nephrogenesis, Renal Function, and Biomarkers in Preterm Newborns, Current Medicinal Chemistry 2022; 29 (23) . https://dx.doi.org/10.2174/0929867328666211101102227
DOI https://dx.doi.org/10.2174/0929867328666211101102227 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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