ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2012, Vol. 21 ›› Issue (4): 317-323.

• 论文 • 上一篇    下一篇

尿液肾损伤分子1:预测梗阻性肾病肾脏预后的生物学标志物

  

  • 出版日期:2012-08-28 发布日期:2012-09-03

uKIM-1 as a prognostic biomarker in patients with obstructive nephropathy

  • Online:2012-08-28 Published:2012-09-03

摘要:

摘 要 目的:探讨尿肾损伤分子1(uKIM-1)、尿中性粒细胞明胶酶相关脂质运载蛋白分子(uNGAL)在梗阻性肾病所致急性肾损伤(AKI)诊断中的价值。随访患者肾功能的变化,评价uKIM-1、uNGAL在预测肾脏预后中的价值。 方法:收集30位梗阻性肾病患者解除梗阻前后不同时相的尿液标本,应用ELISA方法检测uKIM-1、uNGAL水平,进行分析、比较。随访1年,评估uKIM-1、uNGAL在梗阻性肾病肾脏预后判断中的应用价值。 结果:发生AKI的患者uKIM-1和uNGAL水平显著升高,uKIM-1、uNGAL与血清肌酐成正相关,AUC分别为0.943和0.900。肾脏预后差的患者术后72h uKIM-1水平显著升高。ROC曲线分析uKIM-1在肾脏预后判断中的AUC为0.912,敏感度为85.7%,特异度为84.6%。Kaplan-Meier生存曲线分析示出现术后72h尿KIM-1>156.00pg/(mg.Cr),与不良预后呈明显相关性。结论:uKIM-1、uNGAL对诊断梗阻性肾病所致AKI有较高的准确性。术后72h uKIM-1有助梗阻性肾病肾脏预后的判断。

关键词: 肾损伤分子1 , 中性粒细胞明胶酶相关脂质运载蛋白分子 , 梗阻性肾病 , 肾脏预后 急性肾损伤

Abstract:

ABSTRACT   Objective: To evaluate the value of uKIM-1 and uNGAL of detecting AKI caused by obstructive nephropathy. Following up of changes in renal function, to evaluate the value of uKIM-1 and uNGAL as the prognostic indicators of renal outcome. Methodology:The urinary samples of thirty patients with obstructive nephropathy were collected. The levels of uKIM-1 and uNGAL were measured by ELISA at various time intervals. The risk factors of the renal outcome were evaluated. The patients were followed up for at least one year. Results: The Patients with AKI had higher levers of uKIM-1 and uNGAL. The positive correlations between uKIM-1, uNGAL and serum creatinine were found. The AUCs to detect AKI were 0.943 and 0.900. The patients with non complete renal recovery had higher levers of uKIM-1 at 72h postoperative. The AUCs to detect renal prognosis was 0.912. Sensitivity was 85.7% and specificity was 84.6%. Kaplan–Meier analysis revealed that uKIM-1 at 72h postoperative over 156.00pg/mg.Cr predicted progression of renal function. Conclusion: uKIM-1 and uNGAL had good accuracy for detecting AKI. uKIM-1 at 72h postoperative can help predict the renal outcome of obstructive nephropathy.

Key words: KIM-1  , NGAL  , Obstructive Nephropathy , Prognosis Acute Kidney Injury