肝移植术后急性肾损伤的早期诊断

Early diagnosis of acute kidney injury following liver transplantation

背景急性肾损伤（acutekidneyinjury，AKI）为肝移植术后常见严重并发症，其发生威胁患者生存。文献报道AKI发生率差异较大，原因可能与不同研究中AKI的诊断标准不一致有关。目的探讨肝移植术后AKI早期诊断的最新进展，以便积极预防、尽早治疗。内容综述肝移植术后AKI的常用诊断标准及其发生的相关危险因素，并讨论可能的诊断新指标。趋向血肌酐（sel＇umcreatinine，Scr）是目前诊断AKI最常用的生物标志物，但近年来研究指出，中性粒细胞明胶酶相关脂质运载蛋白（neutrophilgelatinase-associatedlipocalin，NGAL）、肾损伤分子-1（kidneyinjurymolecule-1，KIM-1）、胱抑素C（CystatinC，Cys-C）等新型生物学标志物或许可替代Scr，成为早期诊断AKI的理想指标。

Background Acute kidney injury （AKI） is one of common life-threatening complications following liver transplantation, the large difference in incidence reported may be due to the wide disparity in the criteria used to define AKI following liver transplantation. Objective The purpose of this review is to discuss recent development in early diagnosis of AKI following liver transplantation, and for positive prevention and early treatment of AKI following liver transplantation. Content Here we review the common diagnostic criteria, risk factors and possible newly diagnostic biomarkers of AKI following liver transplantation. Trend Serum creatinine （Scr） is still used as the most common biomarkers for diagnosis of AKI. Some newly reported markers such as neutrophil gelatinase-associated lipocalin （NGAL）, kidney injury molecule-1 （KIM-1） and Cystatin C （Cys-C）, may replace Scr and become ideal target for early diagnosis of AKI.