肾损伤分子1在药物相关性急性肾损伤早期诊断中的意义

The significance of kidney injury molecule-1 in the early diagnosis of druginduced acute kidney injury

目的观察肾损伤分子1(KIM-1)在药物相关性急性肾损伤(AKI)患者尿液中的变化,探讨KIM-1在药物相关性AKI早期诊断中的意义。方法将108例药物相关性AKI患者分为轻度AKI组(28例)、中度AKI组(51例)、重度AKI组(29例),终末期肾脏病(ESRD)患者30例和健康对照组30例作为观察对照。采用ELISA方法检测尿液中KIM-1的水平,比色法检测尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的水平,颗粒免疫比浊法检测血液胱抑素C(CysC)的浓度。并对尿KIM-1与NAG、血清肌酐及血清CysC进行相关性分析。结果轻度、中度和重度AKI患者尿液KIM-1显著升高,与健康对照组和ESRD组比较差异均有统计学意义(P<0.05),而ESRD组与健康对照组比较差异无统计学意义(P>0.05)。尿KIM-1升高程度与NAG、血清肌酐和CysC均呈正相关(P<0.05)。结论检测尿液中KIM-1水平,有助于药物相关性AKI的早期临床诊断。

Objective To investigate the significance of kidney injury molecule-1 （KIM-1 ） changes in urine in patients with drug-induced acute kidney injury （AKI）. Methods Clinieal presentations, and urine and serum samples were collected in patients with mild drug-induced AKI （28 cases）, moderate drug-induced AKI （51 cases）, severe drug-induced AKI （39 eases） and end stage renal disease （30 eases）. Urinary KIM-1 was assayed by ELISA, urinary N-acetyl-heta-D-glueosaminidase （NAG） by colorimetrie method, and serum eystatin C by particle enhanced immunoturbidimetry. The correlation analysis between urinary KIM-1 and urinary NAG, serum creatinie or cystatin C were carried out. Results Urinary KIM-1 increased significantly in patients with mild, moderate and severe drug-induced AKI, as compared with that in ESRD patients and normal controls （P〈0.05）. Urinary KIM-1 was correlated with urinary NAG, serum creatinine and cystatin C （P〈0.05）. Conclusion Urinary KIM-1 is a useful marker for the early diagnosis of drug-induced AKI.