Jia and colleagues have concluded that plasma endostatin shows a useful value for predicting failure to recover from acute kidney injury (AKI) [1]. They studied two populations of patients with AKI following non-cardiac major surgery, with the primary endpoint of recovery or “non-recovery” from AKI. Patients classified as “non-recovery” from AKI in fact consisted of two groups, a cohort receiving renal replacement therapy (RRT) at day 7 and another cohort without RRT [1]. We would like to make some comments. Endostatin, the C-terminal fragment of collagen XVIII, is a cytokine with a molecular weight of 20 kDa [2]. It stands to reason that this small molecule can be easily removed by RRT as the cutoff point of filter membranes is about 35 kDa [3]. According to the authors, patients with renal recovery showed endostatin concentrations of 62.6 ng/ml, whereas patients failing to recover showed higher concentrations of 108.5 ng/ml [1]. Also, almost 20% of the AKI population received RRT for 7 days [1]. Considering that endostatin can be removed by RRT, the endostatin values in this group of patients may fall significantly [3]. This could give the clinician the false impression that the patient will recover from AKI. Accordingly, if endostatin is used as a predictive tool in the future, falsely low endostatin values in RRT patients could lead to a premature de-escalation of care for intensive care unit (ICU) patients. There has been no

中文翻译：

---

内皮抑素显示出预测急性肾损伤无法恢复的有用价值：一些需要考虑的混杂因素

Jia 及其同事得出的结论是，血浆内皮抑素在预测急性肾损伤 (AKI) 恢复失败方面具有有用的价值 [1]。他们研究了两组非心脏大手术后的 AKI 患者，主要终点是 AKI 恢复或“未恢复”。归类为 AKI“未恢复”的患者实际上由两组组成，一组在第 7 天接受肾脏替代疗法 (RRT)，另一组未接受 RRT [1]。我们想发表一些意见。内皮抑素是胶原蛋白 XVIII 的 C 端片段，是一种分子量为 20 kDa 的细胞因子 [2]。由于过滤膜的截止点约为 35 kDa [3]，因此可以通过 RRT 轻松去除这种小分子。这组作者说，肾功能恢复的患者的内皮抑素浓度为 62.6 ng/ml，而未能恢复的患者则显示出更高的浓度，为 108.5 ng/ml [1]。此外，几乎 20% 的 AKI 人群接受了 7 天的 RRT [1]。考虑到RRT可以去除内皮抑素，该组患者的内皮抑素值可能会显着下降[3]。这可能会给临床医生造成患者会从 AKI 中康复的错误印象。因此，如果将来使用内皮抑素作为预测工具，那么 RRT 患者中假低的内皮抑素值可能会导致重症监护病房 (ICU) 患者的护理过早降级。没有 这组患者的内皮抑素值可能会显着下降[3]。这可能会给临床医生造成患者会从 AKI 中康复的错误印象。因此，如果将来使用内皮抑素作为预测工具，那么 RRT 患者中假低的内皮抑素值可能会导致重症监护病房 (ICU) 患者的护理过早降级。没有 这组患者的内皮抑素值可能会显着下降[3]。这可能会给临床医生造成患者会从 AKI 中康复的错误印象。因此，如果将来使用内皮抑素作为预测工具，那么 RRT 患者中假低的内皮抑素值可能会导致重症监护病房 (ICU) 患者的护理过早降级。没有