镉诱导肾损伤的早期敏感性检测指标研究进展
Research progress on early sensitive indicators of cadmium-induced kidney injury
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摘要:
镉是最常见的重金属，镉污染是目前较为严重的公共卫生问题。镉慢性毒作用的主要靶器官是肾脏，镉性肾损害主要表现为肾小管的重吸收功能障碍，引起蛋白尿。结合近年来国内外关于镉性肾损伤的研究进展，本文从尿低分子蛋白类、尿液中近端小管衍生的酶类以及血液和组织中肾损伤相关基因的表达三个方面综述了镉诱导肾损伤的早期敏感性检测指标并简单归纳了各指标的优缺点，为人群环境镉暴露，尤其是职业性镉暴露早期诊断提供了更多的检测指标选择依据。本文分析发现，在不同情况下，各指标对镉性肾损伤具有不同的诊断效能，可采用多种指标联合检测的方式，以提高诊断结果的准确性。
Abstract: Cadmium (Cd) is one of the most common heavy metals, and its pollution is currently a major public health concern. Kidney is the main target organ of chronic cadmium toxicity, and cadmium-induced renal damage is mainly manifested as the reabsorption dysfunction of renal tubules, followed by proteinuria. According to related domestic and foreign studies in recent years, we reviewed early sensitive indicators of kidney injury induced by cadmium from three aspects, including urinary low-molecular-weight proteins, urinary proximal tubule derived enzymes, and renal injury-related gene expressions in blood and tissues, and summarized their advantages and disadvantages, aiming to provide evidence for the selection of indicators for the early diagnosis of cadmium exposure in populations, especially of occupational cadmium exposure. This study showed that each indicator had different diagnostic efficacies for cadmium-induced renal injury in different situations; therefore, combination of multiple indicators is suggested to improve the accuracy of diagnosis.
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