微小RNA在急性肾损伤诊断、治疗及预后判断中的意义

正急性肾损伤(acute kidney injury,AKI)是重症患者的常见并发症,其发病率逐年增高,在普通住院患者中AKI的发病率为3%～5%,在ICU中则高达20%～50%,住院患者发生AKI后病死率上升近4倍~1]。其病因包括脓毒症、手术、创/烧伤以及各种肾脏毒性药物如对比剂等~2]。AKI的诊断时间窗为48 h,而早期诊断、早期干预对于AKI的预后至关重

Significance of microRNAs in diagnosis, treatment and prognosis of acute kidney injury

Acute kidney injury (AKI) is a common complication in critically ill patients, and the early and accurate diagnosis of AKI is limited by the definition of KDIGO which relys mainly on urine volume and creatinine. MicroRNAs (miRNAs) are endogenous single-stranded noncoding RNAs of 19-23 nucleotides which regulate gene expression by affecting its target genes, and play an important role in the biological functions of various cells, including proliferation, differentiation, metabolism and apoptosis. In AKI, some miRNAs appear to act pathogenically by promoting inflammation, apoptosis and fibrosis, some may act protectively by exerting anti-inflammatory, anti-apoptotic, anti-fibrotic functions, while others are associated with the severity of AKI in AKI patients, which could predict the survival rate of 28d. This article reviews the mechanism and roles of miRNA in the diagnosis, treatment and prognosis of AKI.