Clinical application value of urinary trace proteins combined detection in the diagnosis of early renal injury in chronic kidney diseases
CHEN Peng1 WANG Xiaoqin2 WANG Lan2,3 WU Wenjing2,3 LONG Sijie1
1.Department of Clinical Laboratory, Academy of Traditional Chinese Medicine Hubei Provincial Hospital of Traditional Chinese Medicine, Hubei Province, Wuhan 430074, China;
2.Department of Nephrology, Academy of Traditional Chinese Medicine Hubei Provincial Hospital of Traditional Chinese Medicine, Hubei Province, Wuhan 430074, China;
3.the First Clinical College, Hubei University of Chinese Medicine, Hubei Province, Wuhan 430065, China
Abstract：Objective To investigate the clinical application value of urinary trace proteins combined detection in the diagnosis of early renal injury in chronic kidney diseases. Methods According to calculated estimated glomerular filtration rate（eGFR）and staging criteria, 521 patients with clinically diagnosed chronic kidney diseases were enrolled and divided into five groups including phase Ⅰ(222 cases), phase Ⅱ（130 cases）, phase Ⅲ（105 cases）, phase Ⅳ（39 cases）, phase Ⅴ（25 cases） in Hubei Provincial Hospital of Traditional Chinese Medicine （“our hospital” for short） from August 2015 to August 2018, while another 86 healthy subjects of our hospital were selected as normal control group. Six urinary trace proteins [Urine retinol binding protein (URBP), urine microalbumin (UmAlb), urine beta 2-microglobulin (Uβ2M), urine transferrin (UTRF), urine immunoglobulin (UIgG) and urine N-acetyl-beta-D glucosamine (UNAG)] and serum creatinine were detected respectively. The results of each group were compared, while analysed the relevance and diagnostic efficiency of urinary trace proteins, and their correlation and consistency with the stages of chronic kidney diseases. The clinical application value of single and combined detection of these markers in the diagnosis of early renal injury in chronic kidney diseases were evaluated. Results The levels of six urinary trace proteins in chronic kidney disease group were higher than those in normal control group, while increased significantly with the progression of disease, and the differences were highly statistically significant (P ＜ 0.01). The relevance of URBP and Uβ2MG as well as UTRF and UmAlb (rp = 0.789, 0.940) was high. Moreover, urinary trace protein UmAlb, UTRF and UIgG reflecting glomerular injury were well interrelated (all rp ＞ 0.6). Grade correlation analysis showed that Uβ2MG and URBP were significantly correlated with eGFR and stages of nephropathy, while other proteins were moderately correlated. However, UNAG was the worst. The correlation between six urinary trace proteins and the stages of chronic kidney diseases was ordinary, and the consistency was general (all Kappa ＜ 0.4). The diagnostic efficiency of urinary trace proteins combined detection was not only superior to that of single index (AUC ＞ 0.958), but also superior to that of serial mode in terms of correlation and consistency with the stages of chronic kidney diseases. Conclusion Urinary trace proteins have their own biological characteristics, and each of them has its own advantages in evaluating early renal injury in chronic kidney diseases. The combined detection of urinary trace proteins has high diagnostic performance and can significantly improve the diagnostic efficiency. It has high clinical application value for early diagnosis, pathological classification, staging monitoring and prognosis evaluation of renal injury in chronic kidney diseases.
陈鹏1 王小琴2 王岚2,3 吴文静2,3 龙思洁1. 尿微量蛋白联合检测对慢性肾病早期肾损伤诊断的临床应用价值[J]. 中国医药导报, 2019, 16(29): 118-123.
CHEN Peng1 WANG Xiaoqin2 WANG Lan2,3 WU Wenjing2,3 LONG Sijie1. Clinical application value of urinary trace proteins combined detection in the diagnosis of early renal injury in chronic kidney diseases. 中国医药导报, 2019, 16(29): 118-123.
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2019, Vol. 16 
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