Renal Angina

被引:147
作者
Goldstein, Stuart L. [2 ]
Chawla, Lakhmir S. [1 ,3 ]
机构
[1] George Washington Univ, Med Ctr, Dept Anesthesiol & Crit Care Med, Washington, DC 20037 USA
[2] Baylor Coll Med, Dept Pediat, Renal Sect, Houston, TX 77030 USA
[3] George Washington Univ, Med Ctr, Dept Med, Div Renal Dis & Hypertens, Washington, DC 20037 USA
来源
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2010年 / 5卷 / 05期
关键词
ACUTE KIDNEY INJURY; CRITICALLY-ILL CHILDREN; FLUID OVERLOAD; RISK-FACTORS; FAILURE; SURVIVAL; BIOMARKERS; ICU; EXPERIENCE; MANAGEMENT;
D O I
10.2215/CJN.07201009
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Small elevations in serum creatinine may reflect significant kidney damage and be associated with poor patient outcomes, thus rendering creatinine to be a late marker of acute kidney injury (AKI). AKI researchers refer to the AKI biomarker quest as the "search for the renal troponin I," implying that such putative earlier AKI biomarker use could allow for earlier intervention. We consider the analogy to troponin I and its acceptance to prompt evaluation and therapeutic intervention to treat myocardial ischemia and prevent myocardial infarction an informative and potentially applicable model to the AKI field. Because AKI does not hurt, there is no validated equivalent of chest pain or anginal equivalent to increase suspicion for AKI presence on the part of the clinician. So, although biomarkers may ultimately be validated to detect AKI early, unless nephrologists and intensivists can define "renal angina" to initiate "renal troponin I" assessments, AKI biomarkers may never realize their full potential to improve patient care and outcomes. The purpose of this article is to review both adult and pediatric AKI literature to devise a definition for a renal anginal syndrome equivalent. Clin J Am Sac Nephrol 5: 943-949, 2010. doi: 10.2215/CJN.07201009
引用
收藏
页码:943 / 949
页数:7
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