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肾脏病与透析肾移植杂志 ›› 2018, Vol. 27 ›› Issue (1): 46-49.DOI: 10.3969/cndt.j.issn.1006-298X.2018.01.009

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尿液血管紧张素原与慢性肾脏病的关联

  

  • 出版日期:2018-02-28 发布日期:2018-03-01

Significance of urine angiotensinogen in patients with chronic kidney disease

  • Online:2018-02-28 Published:2018-03-01

摘要:

目的:探讨尿液血管紧张素原(angiotensinogen,AGT)与慢性肾脏病(CKD)的关联性,以及尿AGT对CKD的诊断价值。
方法:从新疆维吾尔自治区墨玉县农村维吾尔族成人CKD流行病学调查的资源标本库中抽取CKD和非CKD样本,按估算的肾小球滤过率(eGFR)将CKD患者分为CKD 1期组、CKD 2期组、CKD 3期组。尿AGT用ELISA方法检测。onewayANOVA分析组间差异,多因素分析采用多重线性回归分析。
结果:95例CKD患者和413例非CKD对照者进入本研究。CKD组尿液AGT明显高于非CKD组(24397±4786 vs 15843±2514,t=16892,P<001);随着eGFR下降,尿液中AGT呈升高趋势,CKD 1期组、CKD 2期组和CKD 3期组患者尿液AGT分别为21363±3447 ng/L,25139±1717 ng/L和31497±2758 ng/L,各组间有显著差异(F=81103,P<001)。多重线性回归分析表明,尿液AGT与eGFR呈负相关(P<001),与尿白蛋白/肌酐(P<001)和血清肌酐(P<001)呈正相关。
结论:CKD患者尿AGT高于非CKD患者,与eGFR下降呈负相关。提示尿AGT可作为CKD诊断和病程进展的生物学标志物。

关键词: 慢性肾脏病, 血管紧张素原, 肾素-血管紧张素系统

Abstract:

Objective:To analyze the concentration of urine angiotensinogen (AGT) in patients with chronic kidney disease (CKD),and to explore the significance of urinary AGT excretion in the diagnosis of CKD.
Methodology:Clinical data of CKD and non CKD patients from the CKD resource repository in a crosssectional survey were collected. CKD patients were divided into 3 groups according to estimated glomerular filtration rate (eGFR): CKD 1 group, CKD 2 group and CKD 3 group. Urine AGT was detection by ELISA method.
Results:A total of 95 CKD patients and 413 non CKD controls were enrolled in this study. Urine AGT in CKD group was significantly higher than that in non CKD group (2439±479 vs 1584±2514, P<001), With the decrease of eGFR, urine AGT level increased, it was 2136±345 ng/L, 2514±172 ng/L and 3149±276 ng/L in CKD 1 group,  CKD 2 group and CKD 3 group respectively (F=81103, P<001). Multiple linear regression analysis showed that urine AGT was negatively correlated with eGFR (P<001) and positively correlated with urine albumin/creatinine (P<001) and serum creatinine (P<001).
Conclusion:
Urinary AGT excretion was significantly elevated in CKD patients, and it was negatively correlated with eGFR. Urine AGT may be a useful biomarker of CKD.

Key words: chronic kidney disease, angiotensinogen, renin-angiotensin system