Validity of Klotho, CYR61 and YKL-40 as ideal predictive biomarkers for acute kidney injury: review study

ABSTRACT CONTEXT AND OBJECTIVE: Acute kidney injury (AKI) is still a headache for clinicians and scientists as a possible reason for increased death among intensive care unit (ICU) patients after invasive cardiac surgery. Furthermore, the diagnostic process for AKI using conventional biomarkers is not sufficient to ensure early warning of this condition because of the morbid influence of non-renal factors that definitively delay the time for the prognosis. These imposed limitations have led to significant amounts of research targeted towards identifying novel biomarkers for AKI with a sustained degree of sensitivity and specificity. Here, we reviewed previous studies conducted on the Klotho, CYR61 and YKL-40 biomarkers in relation to AKI. DESIGN AND SETTING: Review of the literature conducted in the Institute of Clinical Chemistry & Biochemistry, Ljubljana University Medical Center, Slovenia. METHODS: The literature was searched in PubMed and the Cochrane Library. From the database of this specialty, we selected 17 references that matched our context for detailed analysis and further investigation. RESULTS: The studies reviewed showed notable differences in their results relating to the diagnostic impact of Klotho, CYR61 and YKL-40 on early prediction of AKI. CONCLUSIONS: The results regarding the Klotho, CYR61 and YKL-40 biomarkers showed markedly equivocal performance in the previous studies and did not fulfill the expectations that these factors would form valid possible biomarkers for AKI.

【背景与目标】急性肾损伤（Acute kidney injury, AKI）仍是临床医师与科研人员面临的棘手难题，其为侵入性心脏手术后重症监护病房（Intensive Care Unit, ICU）患者死亡风险升高的潜在诱因之一。此外，由于非肾脏因素的病理性影响会显著延迟预后判定时机，当前使用传统生物标志物开展AKI诊断的流程无法确保对该病实现早期预警。上述局限性促使大量研究致力于筛选兼具稳定灵敏度与特异度的AKI新型生物标志物。本文就Klotho、CYR61及YKL-40三种生物标志物与AKI的相关既往研究进行了综述。
【研究设计与实施机构】本综述由斯洛文尼亚卢布尔雅那大学医学中心临床化学与生物化学研究所完成。
【研究方法】我们在PubMed数据库及Cochrane图书馆中检索相关文献，从该专业数据库中筛选出17篇契合本研究主题的文献，进行详细分析与深入探讨。
【研究结果】所综述的各项研究表明，Klotho、CYR61及YKL-40在AKI早期预测中的诊断价值存在显著差异。
【结论】既往研究中，Klotho、CYR61及YKL-40生物标志物的诊断表现均存在明显不确定性，未达到可作为AKI有效潜在生物标志物的预期标准。