Application value of urine kidney injury molecule-1 in early evaluating the renal function for unilateral obstruction renal disease / 中国医师进修杂志

ABSTRACT

Objective To study the early renal function assessment value of urine kidney injury molecule-1(KIM-1)level in patients with unilateral obstruction renal diseases.Methods Seventy-eight patients with unilateral obstruction renal diseases were selected,and the glomerular filtration rate(GFR) was detected by 99Tcm-diethylene triaminepentaacetic acid (DTPA) renal dynamic imaging method. The patients were divided into 4 groups according to the GFR normal renal function group with GFR>40 ml/(min·1.73 m2)25 cases(A group),low-injury renal function group with 20 ml/(min·1.73 m2)<GFR≤40 ml/(min·1.73 m2) 22 cases (B group), mid-injury renal function group with 10 ml/(min·1.73 m2) <GFR ≤ 20 ml/(min·1.73 m2) 16 cases (C group), serious-injury renal function group with GFR ≤ 10 ml/(min·1.73 m2) 15 cases (D group). Twenty-five healthy people were selected as control group (E group). The urine KIM-1 and serum creatinine and blood urea nitrogen levels were detected. The correlation among urine KIM-1, serum creatinine and blood urea nitrogen was analyzed. Results The urine KIM-1 in A group, B group, C group and D group was significantly higher than that in E group(49.70 ± 9.23),(57.84 ± 10.06),(67.71 ± 7.36)and(65.84 ± 22.48)ng/L vs.(39.17 ± 3.28)ng/L,in A group and B group was significantly higher than that in C group and D group,in A group was significantly higher than that in B group, and there were statistical differences (P<0.05). There was no statistical difference in urine KIM-1 between C group and D group(P>0.05).There was no statistical difference in serum creatinine and blood urea nitrogen among 5 groups (P>0.05). The KIM-1 was negatively correlated with GFR(r=-0.441,P<0.01),and the serum creatinine and blood urea nitrogen were not correlated with GFR (r = -0.115 and 0.019, P>0.05). The receiver operating characteristic curve analysis result showed that the area under curve of urine KIM-1 in the diagnosis of kidney injury was significantly higher than that in serum creatinine and blood urea nitrogen(0.804 vs.0.441 and 0.567);the sensitivity and specificity were 82.6% and 66.7%,56.5% and 53.3%,66.9% and 66.7%.Conclusions The expression level of urine KIM-1 of unilateral obstructive nephropathy with different degree of kidney injury is a higher sensitivity marker compared with serum creatinine and blood urea nitrogen, which is helpful for diagnosing kidney injury early in clinic.