nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2017-21-2-24-32nefr-250Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESДИАГНОСТИЧЕСКАЯ И ПРОГНОСТИЧЕСКАЯ ЦЕННОСТЬ БИОМАРКЕРОВ ПОВРЕЖДЕНИЯ ПОЧЕЧНЫХ КАНАЛЬЦЕВ NGAL, KIM-1, L-FABP У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕКDIAGNOSTIC AND PROGNOSTIC VALUE OF RENAL TUBULAR INJURY BIOMARKERS NGAL, KIM-1, L-FABP IN CHRONIC KIDNEY DISEASE PATIENTSКузьминО. Б.KuzminO. B.

Профессор Кузьмин Олег Борисович.

Кафедра фармакологии.

46000, г. Оренбург, Парковый пр., д. 7.

Prof. Oleg B Kuzmin MD, PhD, DMedSci

Department of Pharmacology. 

460000 Russia, Orenburg, Park st., 7.

kuzmin.orgma@mail.ruЖежаВ. В.ZhezhaV. V.

Доцент Жежа Владислав Викторович, кандидат медицинских наук.

Кафедра фармакологии.

46000, г. Оренбург, Парковый пр., д. 7.

Associate prof. Vladislav V Zhezha, Department of Pharmacology. 

460000 Russia, Orenburg, Park st., 7.

zhezha56@mail.ruБелянинВ. В.BelayninV. V.

Белянин Виталий Васильевич, кандидат медицинских наук. 

Кафедра фармакологии.

46000, г. Оренбург, Парковый пр., д. 7.

Vitaly V Belyanin, Department of Pharmacology. 

460000 Russia, Orenburg, Park st., 7.

 

Vitbelya@yandex.ruБучневаН. В.BuchnevaN. V.

Бучнева Наталья Викторовна, кандидат медицинских наук. 

Кафедра фармакологии.

46000, г. Оренбург, Парковый пр., д. 7.

Natalya V. Buchneva Vladislav V Zhezha, Department of Pharmacology. 

460000 Russia, Orenburg, Park st., 7.

 

buzap01@yandex.ruЛандарьЛ. Н.LandarL. N.

Ландарь Лариса Николаевна, кандидат медицинских наук. 

Кафедра фармакологии.

46000, г. Оренбург, Парковый пр., д. 7.

Larisa N Landar, Department of Pharmacology. 

460000 Russia, Orenburg, Park st., 7.

 

Landar@mail.ruСердюкС. В.SerdyukS. V.

Сердюк Светлана Владимировна, кандидат медицинских наук. 

Кафедра фармакологии.

46000, г. Оренбург, Парковый пр., д. 7.

Svetlana V. Serdyuk, Department of Pharmacology. 

460000 Russia, Orenburg, Park st., 7.

chubsvet@mail.ruОренбургский государственный медицинский университетРоссияOrenburg State Medical UniversityRussian Federation2017030320172122432Copyright © Кузьмин О.Б., Жежа В.В., Белянин В.В., Бучнева Н.В., Ландарь Л.Н., Сердюк С.В., 20172017Кузьмин О.Б., Жежа В.В., Белянин В.В., Бучнева Н.В., Ландарь Л.Н., Сердюк С.В.Kuzmin O.B., Zhezha V.V., Belaynin V.V., Buchneva N.V., Landar L.N., Serdyuk S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/250

В обзоре обобщаются данные о диагностической и прогностической ценности биомаркеров повреждения почек NGAL (липокалин, ассоциированный с желатиназой нейтрофилов), KIM-1 (молекула повреждения почки-1) и L-FABP (печеночная форма белка, связывающего жирные кислоты) у пациентов с ХБП. Наиболее изученным из них является NGAL, прирост содержания которого в моче отражает тяжесть течения ХБП. Повышенный уровень NGAL мочи рассматривается также как прогностический критерий, который позволяет выявлять пациентов с высоким риском неблагоприятного течения заболевания. Повышенный уровень KIM-1 мочи у больных с ХСН позволяет выявлять лиц с тубулоинтерстициальным повреждением почек, имеющим неблагоприятное прогностическое значение, и оценивать у них риски общей смертности и повторной госпитализации по поводу ХСН. Данные, полученные в больших популяциях больных СД 1 и 2 типов с ХБП, показывают, что высокое содержание L-FABP в моче связано с повышенным риском прогрессирования диабетической нефропатии. Высокий уровень этого биомаркера в моче у больных СД 2 типа с С1–2 стадиями ХБП является также неблагоприятным прогностическим маркером повышенного риска развития ИБС и других сердечно-сосудистых осложнений. Диагностическая и прогностическая ценность KIM-1 и L-FABP мочи у больных ХБП разной степени тяжести изучена недостаточно и нуждается в дополнительных клинических исследованиях. 

The review summarized data on the diagnostic and prognostic value of biomarkers of kidney injury NGAL (neutrophil gelatinaseassociated lipocalin), KIM-1 (kidney injury molecule-1) and L-FABP (liver type fatty acid-binding protein) in patients with CKD. The most studied of these is NGAL, increase of its level in urine reflects the severity of CKD. Elevated levels of urinary NGAL evaluated also as a prognostic criterion which allows identifying patients with high risk of unfavorable course of disease. Elevated levels of urinary KIM-1 inpatients with CHF can detect individuals with tubulointerstitial kidney injury, having an adverse prognostic value, and to assess their risk of death or rehospitalization about CHF. Data obtained in large populations of patients with diabetes type 1 and 2 with CKD show that high levels of urinary L-FABP is associated with an increased risk of diabetic nephropathy progression. High levels of this biomarker in urine of patients with diabetes type 2 and stage1-2 CKD is also unfavorable prognostic marker of increased risk of coronary heart disease and other cardiovascular complications. In general, diagnostic and prognostic value of urine KIM-1 and L-FABP in CKD patients with varying severity poorly understood and needs further clinical studies. 

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The authors declare that there are no conflicts of interest present.