Nefrin u mokraći kao rani biološki biljeg hipertenzivne nefropatije

Abstract

Hypertensive nephropathy (HN) is characterized by kidney damage due to chronic high blood pressure. Podocytes play a crucial role in the pathogenesis of HN, thus, nephrin could be important in the early diagnosis of HN. The aim of the study was to investigate the association of urinary nephrin (u-nephrin) levels with clinical and laboratory characteristics in patients with HN and to test diagnostic relevance of u-nephrin as an early biomarker of HN. In this cross-sectional study, 114 subjects were recruited, 84 patients with chronic hypertension (CH) and 30 healthy controls. All patients with CH were classified according to the urinary microalbumin/creatinine ratio (UM/CR) and according to the chronic kidney disease (CKD) stage. Urine samples were collected to estimate the u-nephrin level by ELISA and to determine UM/CR. Blood samples were used for biochemical analyses. We found elevated u-nephrin in 78.3% of normoalbuminuric subjects with CH. The levels of u-nephrin increased gradually with the stage of CKD. ROC curve plotted for u-nephrin showed 89.7% sensitivity and 88.8% specificity, while UM/CR showed a sensitivity of 44.8% and specificity of 86.1% to detect HN in the early stage. It is concluded that u-nephrin can be useful as an early biomarker of HN.Hipertenzivna nefropatija (HN) je obilježena bubrežnim oštećenjem zbog kronično visokog krvnog tlaka. Podociti imaju presudnu ulogu u patogenezi HB pa bi nefrin mogao biti važan u ranoj dijagnostici HN. Cilj ovog istraživanja bio je ispitati povezanost razina nefrina u urinu (u-nefrin) s kliničkim i laboratorijskim značajkama bolesnika s HN, kao i dijagnostičku važnost u-nefrina kao ranog biološkog biljega HN. U ovu poprečnu studiju uključeno je 114 bolesnika, i to 84 bolesnika s kroničnom hipertenzijom (KH) i 30 kontrolnih osoba. Svi bolesnici s KH podijeljeni su prema omjeru mikroalbumina/ kreatinina u mokraći (UM/CR) i prema stadiju kronične bubrežne bolesti (KBB). Prikupljeni su uzorci mokraće kako bi se procijenila razina u-nefrina tehnikom ELISA i odredio UM/CR. Uzorci krvi rabili su se za biokemijske analize. Utvrdili smo povišenu razinu u-nefrina u 78,3% osoba s KH i normalbuminurijom. Razine u-nefrina postupno su rasle sa stadijem KBB. Krivulja ROC za u-nefrin pokazala je osjetljivost od 89,7% i specifičnost od 88,8%, dok je UM/CR pokazao osjetljivost od 44,8% i specifičnost od 86,1% u otkrivanju HN u ranom stadiju. Zaključuje se da bi u-nefrin mogao biti koristan kao rani biološki biljeg HN