Abstract:

ABSTRACT
Objective：To investigate the expression levels of HE4 in the serum of CKD patients and the relationship to CKD progression. Methodology：We prospectively collected the clinical data and serum samples of 112 CKD patients and serum HE4 concentration of the participants were tested using ELISA. Results: CKD patients had significantly higher serum HE4 concentration than the health controls (82.42±46.29 versus 29.85±15.18, P<0.001). Serum HE4 levels were significantly different among CKD stages (P<0.01), but were not significantly different among various pathological types of CKD(P>0.05). HE4 levels in the serum were inversely correlated with estimated glomerular filtration rates (eGFRs) (r=-0.712, P<0.001). In addition, positive correlations were found between serum HE4 levels and age, serum creatinine, blood urea nitrogen, cystatin C and the proportions of tubulointerstitial fibrosis(r=0.377, r=0.476, r=0.561, r=0.612, r=0.487, P<0.01; respectively). Kaplan–Meier survival curves showed that higher serum HE4 level was associated with shorter renal survival duration. Cox multivariate analyses further demonstrated that serum HE4 concentration was an independent prognostic factor for CKD patients (HR = 1.032, P= 0.001). Conclusion: Our study showed that high circulating HE4 levels were associated with adverse kidney disease outcome, suggesting that HE4 is a novel biomarker for CKD progression.

Key words: Chronic kidney diseases, Human epididymis protein 4, Serum, Outcome