老年急性肾损伤患者的诊断标准选择及新型生物标志物的应用进展

Considerations on diagnostic criteria for acute kidney injury in elderly patients and application of novel biomarkers

急性肾损伤(AKI)是指由各种原因引起的肾小球滤过率在短期内急剧下降的临床综合征。老年患者由于肾脏储备功能低下、基础疾病复杂、急性事件频发、临床合并用药种类繁多等原因,导致老年患者的AKI发病率明显高于普通人群,并呈现逐年增加趋势。老年人AKI防治应该重视危险因素识别及早期诊断,现有诊断标准的临床实用性及适用性存在争议,新型的AKI诊断生物标.志物在老年人群AKI诊断中的应用是否可行尚有疑问。本文就老年人AKI的诊断标准选择及新型生物标志物的临床应用进行综述,以期更好地指导老年人AKI的诊治。

Acute kidney injury(AKI)refers to a clinical syndrome in which the glomerular filtration rate decreases sharply in a short period of time due to various causes.Since elderly patients often have low renal functional reserve,complex underlying diseases,frequent acute events and various types of drug combinations,the incidence of AKI in elderly patients is significantly higher than that in the general population and trends upward each year.The prevention and treatment of elderly AKI should place an emphasis on the identification of risk factors and early diagnosis.There is considerable controversy over whether the existing real-world diagnostic criteria are clinically practical and appropriate.The application of novel diagnostic biomarkers for the diagnosis of AKI in the elderly population remains to be justified.This paper reviews considerations on the diagnostic criteria for AKI in the elderly and the clinical application of new biomarkers,in order to arrive at improved diagnosis and treatment recom mendations.