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Безопасность и риск фармакотерапии

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Биомаркеры нефротоксичности: роль и значимость в диагностике лекарственного повреждения почек

https://doi.org/10.30895/2312-7821-2021-9-4-173-184

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Аннотация

Лекарственное поражение почек составляет от 8 до 60% эпизодов острого повреждения почек (ОПП) среди госпитализированных пациентов. Как можно более раннее распознавание этого состояния и своевременное принятие мер по коррекции лечения могут уменьшить количество выявленных случаев почечного повреждения и летальных исходов. Цель работы: анализ данных научной литературы о биомаркерах, используемых при проведении диагностики лекарственного поражения почек. Выявлено, что такие маркеры повреждения почек, как уровень сывороточного креатинина, объем выделяемой мочи, концентрация азота мочевины, экскреция натрия, микроскопия мочевого осадка, ограничены в применении в связи с тем, что они не отражают в полном объеме динамику и степень повреждения почек и не позволяют диагностировать развитие ОПП на ранних этапах. Установлено, что наи более перспективными биомаркерами являются в первую очередь KIM-1, L-FABP, NAG, NGAL, цистатин С, кластерин, β2-микроглобулин, МСР-1, IGFBP7 и TIMP-2. Однако определение концентрации новых биомаркеров в моче или в крови для диагностики ОПП может носить лишь рекомендательный характер, так как клинических и доклинических исследований по установлению валидности такого рода тестов проведено недостаточно. До настоящего времени не разработаны точные алгоритмы оценки рисков развития, диагностики, мониторинга течения и терапии ОПП, основанные на определении наличия и уровней данных маркеров в моче и/или в сыворотке крови. Таким образом, необходимо продолжать исследования различных биомаркеров ОПП и совершенствовать экспериментальные модели (как in vivo, так и in vitro), в том числе для изучения потенциальных нефротоксических свойств уже известных и разрабатываемых лекарственных средств.

Об авторах

О. В. Муслимова
Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации
Россия

Муслимова Ольга Валерьевна, канд. мед. наук

Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация



В. А. Евтеев
Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации
Россия

Евтеев Владимир Александрович

Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация



И. А. Мазеркина
Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации
Россия

Мазеркина Ирина Анатольевна, канд. мед. наук

Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация



Е. А. Сокова
Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации; Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И. М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)
Россия

Сокова Елена Андреевна, канд. мед. наук, доцент

Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация;

Трубецкая ул., д. 8, стр. 2, Москва, 119991, Российская Федерация



А. Б. Прокофьев
Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации
Россия

Прокофьев Алексей Борисович, д-р мед. наук, профессор

Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация



А. В. Шапченко
Федеральное государственное бюджетное образовательное учреждение высшего образования «Московский государственный медико-стоматологический университет имени А. И. Евдокимова» Министерства здравоохранения Российской Федерации
Россия

Шапченко Анна Валерьевна, канд. мед. наук, доцент

ул. Делегатская, д. 20, стр. 1, Москва, 127473, Российская Федерация



Т. В. Александрова
Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации
Россия

Александрова Татьяна Владимировна, канд. мед. наук

Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация



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Муслимова О.В., Евтеев В.А., Мазеркина И.А., Сокова Е.А., Прокофьев А.Б., Шапченко А.В., Александрова Т.В. Биомаркеры нефротоксичности: роль и значимость в диагностике лекарственного повреждения почек. Безопасность и риск фармакотерапии. 2021;9(4):173-184. https://doi.org/10.30895/2312-7821-2021-9-4-173-184

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Muslimova O.V., Evteev V.A., Mazerkina I.A., Sokova E.A., Prokofiev A.B., Shapchenko A.V., Alexandrova T.V. Nephrotoxicity Biomarkers: Role and Significance in the Diagnosis of Drug-Induced Kidney Injury. Safety and Risk of Pharmacotherapy. 2021;9(4):173-184. (In Russ.) https://doi.org/10.30895/2312-7821-2021-9-4-173-184

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