血清RBP4作为CKDu诊断辅助生物标志物的评价

H. Swa, B. Fernando, Shakila Premarathna, Asfa Alli-Shaik, Z. Badurdeen, Jayantha Gunarathna, N. Nanayakkara
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引用次数: 2

摘要

背景:一种慢性间质性疾病,病因不明的慢性肾脏疾病(CKDu),已经成为斯里兰卡农村CKD负担的一个显著因素。大多数CKD的治疗和诊断方法都集中在肾小球疾病上,因此并不完全适用于CKDu。血清蛋白,特别是那些具有代表疾病不同方面的标志物的蛋白,对疾病的全面评估是有益的,因此在CKD中也是如此。我们的目的是确定血清视黄醇结合蛋白4 (RBP4)在CKDu诊断中的作用,RBP4是近端小管的标志物。方法:从Girandurukotte和Wilgamuwa(流行地区)的肾脏诊所招募明确的CKDu病例。健康对照从Mandaramnuwara(非流行区)招募。测定血清RBP4和肌酐水平。对血清样品进行免疫测定(ELISA)。根据eGFR对CKD/ CKDu分期进行分类。结果:与CKD患者和健康对照组相比,CKDu患者血清RBP4明显升高。结果表明,与健康对照相比,标准化血清RBP4与血清肌酸比值(S.cr)作为CKDu (AUC 0.762,敏感性0.733)优于CKD (AUC 0.584,敏感性0.733)的竞争标志物。此外,RBP4:S。RBP4: S.cr比值在CKDu和CKD之间具有较高的鉴别能力(AUC为0.743),提示RBP4: S.cr比值有可能作为CKDu和CKDu的血清鉴别指标。结论:RBP4: S.cr比值可作为鉴别CKDu与CKD的可靠指标,其敏感性和特异性均为70%。因此,可用于评价CKD的肾小管间质受累情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating Serum RBP4 as an Auxiliary Biomarker for CKDu Diagnosis
Background: A chronic interstitial disease, chronic kidney disease of uncertain etiology (CKDu), has emerged as a notable contributor to the CKD burden in rural Sri Lanka. Most therapeutic and diagnostic approaches to CKD focus on glomerular diseases, and thus are not fully applicable to CKDu. Serum proteins, specifically those with the profile of markers representing different facets of a disease, are beneficial for a comprehensive evaluation of diseases, and hence in CKD. Our aim was to identify the role of serum-retinol-binding protein 4 (RBP4), a marker of the proximal tubule, in the diagnosis of CKDu. Methods: Definite CKDu cases were recruited from the renal clinic in Girandurukotte and Wilgamuwa (endemic regions). Healthy controls were recruited from Mandaramnuwara (nonendemic area). The levels of RBP4 and creatinine in serum were measured. An immunoassay (ELISA) was performed on the serum samples. The stages of CKD/ CKDu were classified according to eGFR. Results: Serum RBP4 was significantly increased in CKDu patients compared to CKD patients and healthy controls. The results show that the ratio of normalized serum RBP4 to serum creatine (S.cr) acts as a better competitive marker for CKDu (AUC 0.762, sensitivity 0.733) than CKD (AUC 0.584, sensitivity 0.733) when compared against healthy controls. Furthermore, the RBP4:S.cr ratio showed higher discriminating power (AUC 0.743) between CKDu and CKD, suggesting that the RBP4: S.cr ratio has potential as a serum marker to differentiate CKDu from CKDu. Conclusion: The RBP4: S.cr ratio was identified as a plausible indicator for differentiating CKDu from CKD with >70% sensitivity and specificity. Therefore, it could be used in the evaluation of the tubular interstitial involvement of CKD.
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