Objective:Urinary tract infection(UTI)is a common cause of morbidity and hospitalisation in the population worldwide.Upper UTI is indolent and causes subclinical acute kidney injury(AKI)resulting in preventable cause ...Objective:Urinary tract infection(UTI)is a common cause of morbidity and hospitalisation in the population worldwide.Upper UTI is indolent and causes subclinical acute kidney injury(AKI)resulting in preventable cause of scarring of renal parenchyma.We explored urinary and serum levels of kidney injury molecule-1(KIM-1),haematological parameters and quantitative urine microscopy parameters to predict kidney injury.Methods:Neutrophilelymphocyte ratio(NLR)is obtained by dividing absolute neutrophil count with absolute lymphocyte count.Quantitative urine sediment microscopy was performed and correlated with clinical,biochemical and haematological findings to predict AKI in patients with UTI.Quantitative ELISA was performed for serum and urine levels of KIM-1.Seventy two adult patients with UTI were enrolled,45 of whom had AKI while 27 were in the non-AKI group.Results:NLR(p=0.005)and renal tubular epithelial cell-granular cast score in quantitative urine microscopy(p=0.008)are strong predictors of AKI in patients with UTI while rest of quantitative urine microscopy parameters and serum and urinary levels of KIM-1 molecule were not found to be useful in prediction of AKI.Conclusion:NLR in haemogram is a novel and useful biomarker for predicting AKI in patients with UTI.展开更多
BACKGROUND Patients with chronic hepatitis B(CHB)with long-term nucleos(t)ide therapy may experience renal insufficiency.Traditional renal function indicators,such as urine protein,serum urea nitrogen(BUN),and serum c...BACKGROUND Patients with chronic hepatitis B(CHB)with long-term nucleos(t)ide therapy may experience renal insufficiency.Traditional renal function indicators,such as urine protein,serum urea nitrogen(BUN),and serum creatinine,are normal when early mild lesions occur.Therefore,more sensitive renal function indicators are needed.AIM To investigate the significance of early renal injury indicators in evaluating renal injury in patients with CHB with long-term nucleos(t)ide therapy.METHODS We collected the clinical data of 69 outpatients with CHB at Peking University First Hospital from March 2018 to January 2020 who had been treated with longterm nucleos(t)ide therapy and analyzed the results of early renal injury indicators.Continuous normal distribution data were analyzed by the t-test to determine the difference between two groups.Continuous non-normally distributed data were analyzed by the Mann-Whitney U-test between two groups.The Kruskal-Wallis H test was used to determine the differences among multiple groups.Enumeration data were analyzed by the chi-square test.The related factors of early renal injury indicators were analyzed by logistic regression analysis.RESULTS The average treatment duration with nucleos(t)ide analogs of the 69 patients with CHB was 99.7±28.7 mo.The cases of patients with elevated BUN and hypophosphatemia were 6(8.7%)and 13(18.8%),respectively;31(44.9%)patients had abnormal early renal injury indicators,including 9 patients with abnormal urine microalbumin,7 patients with abnormal urine immunoglobulin,6 patients with abnormal urine transferrin,and 19 patients with abnormalα1 microglobulin.There were no significant differences in the mean values of age,sex,BUN,estimated glomerular filtration rate(eGFR),serum uric acid,serum calcium,or serum phosphorus between the two groups of patients with and without early renal injury indicators.However,the mean levels of serum creatinine and urine creatinine,N-acetyl-β-D-glucosidase enzyme,α1 microglobulin,and urine immunoglobulin in the former group of patients were significantly higher than those in the latter group of patients(P<0.05).The incidence of early renal injury in patients with eGFR≥90,60-89,and 30-59 mL/(min·1.73 m2)was 36.4%(8/22),47.6%(20/42),and 60%(3/5),respectively.Logistic regression analysis results showed that gamma-glutamyl transpeptidase[odds ratio(OR)=1.05(1.008-1.093),P=0.020],direct bilirubin[OR=1.548(1.111-2.159),P=0.010],serum creatinine[OR=1.079(1.022-1.139),P=0.006],and age[OR=0.981(0.942-1.022),P=0.357]were independent predictors of early renal injury.CONCLUSION Patients with CHB treated with long-term nucleos(t)ide analog therapy had a high probability of early renal injury,and early renal injury indicators were highly sensitive and could be used to monitor early renal impairment.展开更多
Urinary kidney injury molecule 1(uKIM-1)serves as a reliable marker for the early diagnosis of acute kidney injury(AKI).The rapid and facile detection of changes in uKIM-1 is essential for early AKI diagnosis,ultimate...Urinary kidney injury molecule 1(uKIM-1)serves as a reliable marker for the early diagnosis of acute kidney injury(AKI).The rapid and facile detection of changes in uKIM-1 is essential for early AKI diagnosis,ultimately improving the prognosis of patients.In this study,we developed a fully printed photonic crystal-integrated microarray with photonic crystal-enhanced fluorescence properties,which can detect uKIM-1 levels at the point-of-care.We confirmed its efficacy in the early diagnosis of AKI using clinical urine specimens.Direct quantitative detection of uKIM-1 was achieved within 10 min.The lowest limit of detection is 8.75 pg·mL^(-1) with an accuracy of 94.2%.The diagnostic efficacy was validated using 86 clinical urine samples,highlighting the high sensitivity and stability of the photonic crystal microarray.Consequently,a facile and reliable immunoassay was designed and prepared for the rapid quantitative detection of uKIM-1,which is crucial for the early identification and convenient detection of AKI in hospital or community settings.Rapid,convenient,cost-effective,and long-term monitoring of changes in uKIM-1 levels can assist clinicians in making timely adjustments to treatment regimens,preventing the transition from AKI to chronic kidney disease(CKD),improving the quality of life of patients with AKI,and reducing healthcare costs.It highlights the advantages of utilizing urine samples as a noninvasive and easily accessible medium for early detection and monitoring of kidney-related conditions.展开更多
目的对特发性膜性肾病(IMN)患者尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及肾损伤分子-1(KIM-1)的水平进行检测,探讨其与肾小管间质损伤和IMN病理分期的关系,由此判断其临床价值。方法选自山西医科大学第二医院肾内科2017年5月到2018...目的对特发性膜性肾病(IMN)患者尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及肾损伤分子-1(KIM-1)的水平进行检测,探讨其与肾小管间质损伤和IMN病理分期的关系,由此判断其临床价值。方法选自山西医科大学第二医院肾内科2017年5月到2018年8月行肾穿刺活检确诊为IMN的患者81例为病例组,另选择同期健康体检者55例作为对照组,对所有研究对象行尿NGAL及KIM-1检测。依据Ehrenreich-Churg分期法对病例组进行分期,分为Ⅰ期和Ⅱ期两组;参照Banff病理评价标准IMN理损伤程度分为轻度、中度和重度三组;对不同组别患者尿NGAL及KIM-1水平进行比较分析,探讨IMN患者尿NGAL和KIM-1与肾小管间质病理损伤程度的关系,并分析尿NGAL及KIM-1与肾小管间质损伤相关临床化验指标[α1微球蛋白(α1-MG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)及尿视黄醇结合蛋白(RBP)]的相关性,进而绘制对IMN患者肾小管间质损伤诊断效能的ROC曲线。结果病例组尿KIM-1[0.49(0.15,1.44)μg/L vs 0.06(0.04,0.17)μg/L,Z=6.91,P<0.01]、尿NGAL水平[34.72(21.15,72.92)μg/L vs 9.54(6.17,19.56)μg/L,Z=7.38,P<0.01]明显高于对照组,差异有统计学意义。病例组Ⅰ期、Ⅱ期患者尿KIM-1、尿NGAL水平、肾小管间质损伤评分比较差异有统计学意义(P<0.01)。肾小管间质损伤轻度、中度、重度三组尿KIM-1水平、尿NGAL水平比较差异有统计学意义(P<0.01)。Spearman直线相关分析显示,IMN患者尿KIM-1和NGAL分别与尿RBP、尿α1-MG、尿NAG呈正相关关系(P<0.05)。ROC曲线结果显示,尿KIM-1、NGAL及二者联合检测对IMN患者肾小管间质损伤诊断效能的曲线下面积(AUC)为0.850、0.874、0.916,特异度分别为95.1%、92.6%和92.7%,敏感度分别为63.6%、69.1%和75.3%。而尿RBP、尿α1-MG、NAG的AUC为0.712、0.636、0.719,特异度分别为51.9%、58.0%和59.4%,敏感度分别为81.8%、67.3%和83.6%。结论尿KIM-1和NGAL与IMN肾小管间质损伤严重程度密切相关,并且可以反映IMN病理损伤严重程度,二者联合检测对诊断IMN肾小管损伤具有较高的临床价值。展开更多
基金an Insitutte of National Importance under Ministry of Health and Family Welfare,Government of India,for the Intramural funding for the research study.Project No.95/JIP/Res/Intra-MSc/Phase 2/Grant 3/2016-2017 dated 07.01.2017.
文摘Objective:Urinary tract infection(UTI)is a common cause of morbidity and hospitalisation in the population worldwide.Upper UTI is indolent and causes subclinical acute kidney injury(AKI)resulting in preventable cause of scarring of renal parenchyma.We explored urinary and serum levels of kidney injury molecule-1(KIM-1),haematological parameters and quantitative urine microscopy parameters to predict kidney injury.Methods:Neutrophilelymphocyte ratio(NLR)is obtained by dividing absolute neutrophil count with absolute lymphocyte count.Quantitative urine sediment microscopy was performed and correlated with clinical,biochemical and haematological findings to predict AKI in patients with UTI.Quantitative ELISA was performed for serum and urine levels of KIM-1.Seventy two adult patients with UTI were enrolled,45 of whom had AKI while 27 were in the non-AKI group.Results:NLR(p=0.005)and renal tubular epithelial cell-granular cast score in quantitative urine microscopy(p=0.008)are strong predictors of AKI in patients with UTI while rest of quantitative urine microscopy parameters and serum and urinary levels of KIM-1 molecule were not found to be useful in prediction of AKI.Conclusion:NLR in haemogram is a novel and useful biomarker for predicting AKI in patients with UTI.
基金Supported by the National 12th Five-Year Plan for Science and Technology,No.2018ZX10725-506.
文摘BACKGROUND Patients with chronic hepatitis B(CHB)with long-term nucleos(t)ide therapy may experience renal insufficiency.Traditional renal function indicators,such as urine protein,serum urea nitrogen(BUN),and serum creatinine,are normal when early mild lesions occur.Therefore,more sensitive renal function indicators are needed.AIM To investigate the significance of early renal injury indicators in evaluating renal injury in patients with CHB with long-term nucleos(t)ide therapy.METHODS We collected the clinical data of 69 outpatients with CHB at Peking University First Hospital from March 2018 to January 2020 who had been treated with longterm nucleos(t)ide therapy and analyzed the results of early renal injury indicators.Continuous normal distribution data were analyzed by the t-test to determine the difference between two groups.Continuous non-normally distributed data were analyzed by the Mann-Whitney U-test between two groups.The Kruskal-Wallis H test was used to determine the differences among multiple groups.Enumeration data were analyzed by the chi-square test.The related factors of early renal injury indicators were analyzed by logistic regression analysis.RESULTS The average treatment duration with nucleos(t)ide analogs of the 69 patients with CHB was 99.7±28.7 mo.The cases of patients with elevated BUN and hypophosphatemia were 6(8.7%)and 13(18.8%),respectively;31(44.9%)patients had abnormal early renal injury indicators,including 9 patients with abnormal urine microalbumin,7 patients with abnormal urine immunoglobulin,6 patients with abnormal urine transferrin,and 19 patients with abnormalα1 microglobulin.There were no significant differences in the mean values of age,sex,BUN,estimated glomerular filtration rate(eGFR),serum uric acid,serum calcium,or serum phosphorus between the two groups of patients with and without early renal injury indicators.However,the mean levels of serum creatinine and urine creatinine,N-acetyl-β-D-glucosidase enzyme,α1 microglobulin,and urine immunoglobulin in the former group of patients were significantly higher than those in the latter group of patients(P<0.05).The incidence of early renal injury in patients with eGFR≥90,60-89,and 30-59 mL/(min·1.73 m2)was 36.4%(8/22),47.6%(20/42),and 60%(3/5),respectively.Logistic regression analysis results showed that gamma-glutamyl transpeptidase[odds ratio(OR)=1.05(1.008-1.093),P=0.020],direct bilirubin[OR=1.548(1.111-2.159),P=0.010],serum creatinine[OR=1.079(1.022-1.139),P=0.006],and age[OR=0.981(0.942-1.022),P=0.357]were independent predictors of early renal injury.CONCLUSION Patients with CHB treated with long-term nucleos(t)ide analog therapy had a high probability of early renal injury,and early renal injury indicators were highly sensitive and could be used to monitor early renal impairment.
基金supported by the National Natural Science Foundation of China(Nos.82170684,52222313,22075296,91963212,82000004)the Health Care Program Foundation of PLA(No.21BJZ17)+2 种基金the Youth Independent Innovation Science Fund of the General Hospital of the People’s Liberation Army(No.22QNFC007)the Youth Innovation Promotion Association CAS(No.2020032)the Intramural Research Fund of Peking University International Hospital(No.YN2021QN05).
文摘Urinary kidney injury molecule 1(uKIM-1)serves as a reliable marker for the early diagnosis of acute kidney injury(AKI).The rapid and facile detection of changes in uKIM-1 is essential for early AKI diagnosis,ultimately improving the prognosis of patients.In this study,we developed a fully printed photonic crystal-integrated microarray with photonic crystal-enhanced fluorescence properties,which can detect uKIM-1 levels at the point-of-care.We confirmed its efficacy in the early diagnosis of AKI using clinical urine specimens.Direct quantitative detection of uKIM-1 was achieved within 10 min.The lowest limit of detection is 8.75 pg·mL^(-1) with an accuracy of 94.2%.The diagnostic efficacy was validated using 86 clinical urine samples,highlighting the high sensitivity and stability of the photonic crystal microarray.Consequently,a facile and reliable immunoassay was designed and prepared for the rapid quantitative detection of uKIM-1,which is crucial for the early identification and convenient detection of AKI in hospital or community settings.Rapid,convenient,cost-effective,and long-term monitoring of changes in uKIM-1 levels can assist clinicians in making timely adjustments to treatment regimens,preventing the transition from AKI to chronic kidney disease(CKD),improving the quality of life of patients with AKI,and reducing healthcare costs.It highlights the advantages of utilizing urine samples as a noninvasive and easily accessible medium for early detection and monitoring of kidney-related conditions.
文摘目的对特发性膜性肾病(IMN)患者尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及肾损伤分子-1(KIM-1)的水平进行检测,探讨其与肾小管间质损伤和IMN病理分期的关系,由此判断其临床价值。方法选自山西医科大学第二医院肾内科2017年5月到2018年8月行肾穿刺活检确诊为IMN的患者81例为病例组,另选择同期健康体检者55例作为对照组,对所有研究对象行尿NGAL及KIM-1检测。依据Ehrenreich-Churg分期法对病例组进行分期,分为Ⅰ期和Ⅱ期两组;参照Banff病理评价标准IMN理损伤程度分为轻度、中度和重度三组;对不同组别患者尿NGAL及KIM-1水平进行比较分析,探讨IMN患者尿NGAL和KIM-1与肾小管间质病理损伤程度的关系,并分析尿NGAL及KIM-1与肾小管间质损伤相关临床化验指标[α1微球蛋白(α1-MG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)及尿视黄醇结合蛋白(RBP)]的相关性,进而绘制对IMN患者肾小管间质损伤诊断效能的ROC曲线。结果病例组尿KIM-1[0.49(0.15,1.44)μg/L vs 0.06(0.04,0.17)μg/L,Z=6.91,P<0.01]、尿NGAL水平[34.72(21.15,72.92)μg/L vs 9.54(6.17,19.56)μg/L,Z=7.38,P<0.01]明显高于对照组,差异有统计学意义。病例组Ⅰ期、Ⅱ期患者尿KIM-1、尿NGAL水平、肾小管间质损伤评分比较差异有统计学意义(P<0.01)。肾小管间质损伤轻度、中度、重度三组尿KIM-1水平、尿NGAL水平比较差异有统计学意义(P<0.01)。Spearman直线相关分析显示,IMN患者尿KIM-1和NGAL分别与尿RBP、尿α1-MG、尿NAG呈正相关关系(P<0.05)。ROC曲线结果显示,尿KIM-1、NGAL及二者联合检测对IMN患者肾小管间质损伤诊断效能的曲线下面积(AUC)为0.850、0.874、0.916,特异度分别为95.1%、92.6%和92.7%,敏感度分别为63.6%、69.1%和75.3%。而尿RBP、尿α1-MG、NAG的AUC为0.712、0.636、0.719,特异度分别为51.9%、58.0%和59.4%,敏感度分别为81.8%、67.3%和83.6%。结论尿KIM-1和NGAL与IMN肾小管间质损伤严重程度密切相关,并且可以反映IMN病理损伤严重程度,二者联合检测对诊断IMN肾小管损伤具有较高的临床价值。
