关键词:  , 尿CD80； 肾病综合征； 肾小球微小病变； 局灶节段性肾小球硬化； 白细胞介素13

Abstract:

【Abstract】 Objective: We investigated the level of urinary CD80 in patients with minimal change disease (MCD) and with focal segmental glomerulosclerosis (FSGS) to explore whether it could be helpful in differentiating MCD from FSGS. Methodology: Thirty five patients with biopsy proven MCD were studied including 9 cases of primary MCD, 10 cases of relapse and 16 cases of remission. The patients in the first two groups were manifested by nephrotic syndrome. 18 patients with biopsy proven FSGS were aiso included in the study. The clinical and chemical data were recorded. Urinary CD80(ng/ml) was measured using a commercially available ELISA kit and the results were adjusted by using urinary creatinine excretion. IL-13 levels of serum were evaluated by ELISA kit. Results: A significant increase of urinary CD80, normalized to urinary creatinine, was found in patients with MCD with nephrotic syndrome compared to those in remission (P<0.05) and those with FSGS (P<0.05). No significant differences of urinary CD80 were seen between MCD in remission and those with FSGS (P=0.079), neither between primary MCD and those in relapse (P=0.121). In paired study on the cases of primary MCD patients, the level of urinary CD80 in all the patients having a remission after treatment was statistically lower than that before treatment (Z=2.666,P=0.008). No significant differences of serum IL-13 were seen in these two groups (Z=0.847, P=0.397). There was no difference of serum concentrations of IL-13 among those three groups (P>0.05). In patients of MCD with nephrotic syndrome, there was no correlation between urinary CD80 and proteinuria (r=-0.219, P=0.369), neither between urinary CD80 and serum IL-13 (r=0.303, P=0.205). ROC-AUC of urinary CD80 for differential diagnosis between MCD and FSGS was 0.883（cut off 194.5ng/ml，sensibility 78.9%，specificity 88.9%）.Conclusions: Urinary CD80 might be related to the development of MCD in the patients with nephrotic syndrome. Urinary CD80 may be a useful marker to differentiate between MCD and FSGS.

Key words: urinary CD80, nephrotic syndrome, minimal change disease, FSGS, IL-13