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Objective To investigate the application value of Multi-Latex polygranular technique joint detection of kidney injury-related urinary microproteins in noninvasive diagnosis after renal transplantation. Methods Clinical data of 72 recipients undergoing renal transplantation were retrospectively analyzed. According to the level of serum creatinine (Scr), the recipients were divided into normal renal function group (group A, n=14), mild kidney injury (group B, n=37), and severe kidney injury group (group C, n=21). 20 healthy volunteers were selected as the healthy control group (HC group). The contents of urinary retinol binding protein (RBP), microalbumin (mAlb), IgG, transferrin (TRF), α1-microglobulin (MG), and β2-MG of subjects in each group were detected using the Multi-Latex polygranular technique. The correlation between urinary microproteins and Scr, blood urea nitrogen (BUN) was analyzed. The differences of urinary microproteins in each group were compared. And the diagnostic value of single and joint detection of urinary microproteins was evaluated. Results Six kinds of urinary microproteins in HC group and group A were significantly lower than those in group B and group C, and six kinds of urinary microproteins in group B were significantly lower than those in group C (all P < 0.01). Six kinds of urinary microproteins in renal transplant recipients were positively correlated with BUN. RBP, mAlb, α1-MG, and β2-MG were positively correlated with Scr. The correlations were statistically significant (P < 0.001-0.05). The diagnostic value of joint detection of urinary microproteins is better than the detection of single index, among which TRF+mAlb+RBP+α1-MG quadruple detection had the highest diagnostic value. Conclusions Six kinds of urinary microproteins can be used as specific indicators to reflect graft renal function. The polygranular technique can simultaneously detect its contents and achieve noninvasive diagnosis. The diagnosis based on TRF+mAlb+RBP+α1-MG quadruple detection is expected to further improve the noninvasive diagnosis system after renal transplantation.
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Objective To investigate the effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein regulation.Methods Patients were randomly divided into two groups.The control group received benazepine hydrochloride only.The experimental group received benazepine and spironolactone treatment.The blood pressure,renal function,24 h urinary protein,Cys-C,GFR,urinary microprotein and the correlation of GFR with Cys-C and urinary microprotein were recorded.Results There was no statistically significant difference between two groups in blood pressure(P>0.05).After treatment,the renal function of the experimental group was significantly improved compared to that of the control group.The 24 h urine protein,Cys-C and urinary microprotein were significantly lower in the experimental group than the control group(P<0.05).GFR was negatively correlated with Cys-C and urinary microprotein.Conclusion The com-bination therapy of ACEI and aldosterone receptor antagonist can improve renal function and reduce 24 h hematuria.GFR fil-tration ability was significantly improved with the reduction of Cys-C and urinary microprotein.
ABSTRACT
En las glomerulopatías, las Microproteínas Urinarias (MU) se eliminan por distintos mecanismos fisiopatológicos. El objetivo del trabajo fue correlacionar las MU con el daño histológico evaluado en la punción biopsia renal (PBR) de pacientes con diversas glomerulopatías. Se estudiaron 44 orinas espontáneas (33 mujeres y 11 varones) entre 18 y 71 años de edad, por el método de electroforesis bidimensional de uso clínico (2D UC). Las proteínas identificadas se dividieron en 5 grupos y se compararon con lesiones vasculares, glomerulares y túbulointersticiales; estas dos últimas se dividieron en crónicas y agudas. Las del grupo identificado como las "Tres Marías" (fragmento de 35 kDa de la proteína inhibidor de tripsina cadena pesada H4, Prostaglandina H2 sintasa y fragmento de 23 kDa del Perlecan) resultaron no ser marcadoras de daño tubular, sino de alteraciones glomerulares crónicas. La presencia de las mismas, con proteinuria, se observa antes de la caída de la filtración glomerular (<60 mL/min) y correlaciona con el 30% de glomérulos totalmente esclerosados (p<0,001). El grupo Triángulo, en la glomerulopatía, contiene a la Alfa-1 microglobulina (A1m) y a las cadenas livianas libres de Inmunoglobulinas (CLL), e indica lesión glomerular activa. Por lo tanto, las MU en glomerulopatías, responden a lesiones glomerulares activas y crónicas. Los perfiles proteicos urinarios hallados por la 2D UC permitieron conocer el grado de lesión en los distintos compartimentos renales.
In Glomerulopathies, urinary microproteins (UM) are eliminated by different pathophysiological mechanisms. The objective of this work was to correlate the UM with the histological damage evaluated in the renal biopsy through puncture of patients with various glomerular diseases. Forty-four urine samples (33 females, 11 males) aged 18 to 71 years old were studied by the method of two-dimensional electrophoresis of clinical use (2D UC). The identified proteins were divided into 5 groups and were compared with vascular injury, glomerular and tubulointerstitial injury, the latter in chronic and acute cases. The group identified as the "Three Marias" (fragment 35 kDa protein trypsin inhibitor heavy chain H4, prostaglandin H2 synthase and 23 kDa fragment of Perlecan), was not found as marker of tubular damage, but it was found in chronic glomerular disorders. The presence of this same group -with proteinuria- is seen before the collapse of the glomerular filtration rate (<60 mL/min) and it is correlated with 30% of fully sclerotic glomeruli (p<0.001). In glomerulopathy, the Triangle group: Alpha-1 microglobulin (A1m) and free Immunoglobulin light chains (FLC), indicates active glomerular injury. Therefore, the UM in glomerular diseases, respond to active and chronic glomerular lesions. Urinary protein profiles found by the 2D UC made it possible to know the degree of renal injury in different renal compartments.
Nas glomerulopatias, as Micro proteínas Urinárias (MU) são eliminadas através de diferentes mecanismos fisiológicos. O objetivo do trabalho foi relacionar as MU com o dano histológico avaliado na punção biópsia renal (PBR) de pacientes com diversas glomerulopatias. Foram estudadas 44 urinas espontâneas (33 mulheres e 11 homens entre 18 e 71 anos de idade), pelo método de eletroforese bidimensional de uso clínico (2D UC). As proteínas identificadas foram divididas em 5 grupos e comparadas com lesões vasculares, glomerulares e túbulo-intersticiais, estas duas últimas classificadas em crônicas e agudas. O grupo identificado como as "Três Marias" (fragmento de 35 kDa da proteína inibidora de tripsina cadeia pesada H4, Prostaglandina H2 sintase e fragmento de 23 kDa do Perlecam), resultaram não ser marcadoras de dano tubular, mas de alterações glomerulares crônicas. A presença de tais proteínas, com proteinúria, observa-se antes da queda da filtragem glomerular (<60 mL/min) e correlaciona com 30% de glomérulos totalmente esclerosados (p<0,001). O grupo Triângulo, na glomerulopatia, que contém a Alfa-1 microglobulina (A1m) e as cadeias leves livres de Imunoglobulinas (CLL) indicam lesão glomerular ativa. Portanto, as MU em glomerulopatias respondem a lesões glomerulares ativas e crônicas. Os perfis proteicos urinários encontrados pela 2D UC permitiram conhecer o grau de lesão nos diferentes compartimentos renais.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Biopsy, Needle , Kidney , Proteins , Urine Specimen Collection , Epidemiology, Descriptive , Ligases , Observational Study , Prostaglandin H2ABSTRACT
Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy (DN).Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table,the control group was treated with the conventional treatment,the observation group was treated with atorvastatin on the basis of conventional treatment,then blood lipids,serum cystatin C,urinary albumin excretion rate (UAER),microalbuminuria( MAU ),α1-microglobulin(MG),β 2-MG between the two groups were compared.Results After intervention,the levels of total cholesterol (TC),triacylglycerol (TG),serum cystatin C,UAER,MAU,αt 1-MG,β 2-MG were significantly decreased compared with those before treatment in the observation group [ (4.32 ± 1.26) mmol/L vs.(5.65 ± 1.38 ) mmol/L,( 1.67 ± 0.64) mmol/L vs.(2.53 ± 0.96 ) mmol/L,( 1.29 ± 0.38 ) mg/L vs.( 1.74 ± 0.51 ) mg/L,(61.09 ± 18.45 ) μ g/min vs.( 86.42 ± 21.34) μ g/min,( 5.73 ±4.81) mg/L vs.(23.16 ±9.73) mg/L,(1.41 ± 1.21) mg/L vs.(4.76 ± 1.24) mg/L,(1.21 ±0.13) mg/L vs.(2.58 ± 0.26) mg/L ] (P ＜ 0.01 or ＜ 0.05 ).In the control group,the levels of TC,TG,serum cystatin C were lower than those before treatment,but there were no significant differences (P＞0.05),but the levels of UAER,MAU,α 1-MG,β 2-MG had significant differences compared with those before treatment (P ＜ 0.01or ＜ 0.05 ) and the same time of the observation group (P ＜ 0.05 or ＜ 0.01 ).Conclusion Atorvastatin can significantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN,which plays an important role in kidney protection.