Study on the diagnostic value of renal injury molecule-1 and β2-microglobulin concentration in pregnancy induced hypertension with early renal injury / 中国综合临床

ABSTRACT

Objective:To investigate the diagnostic value of renal injury molecule-1 (KIM-1) and β2-microglobulin (β2-MG) concentration in hypertensive disorder of pregnancy (HDP) complicated with early renal injury.Methods:From July 2017 to October 2018, the clinical data of 56 pregnant women with HDP complicated with renal injury and 56 normal pregnant women in the same period in Xi′an Central Hospital were analyzed retrospectively.The pregnant women with HDP complicated with renal injury were the observation group and the 56 normal pregnant women were the control group.The difference of serum creatine (SCr), KIM-1, β2-MG concentration between the two groups at 30, 32, 34 and 36 weeks of gestation was compared, and the value of KIM-1, β2-MG combined diagnosis of early renal injury in HDP was analyzed.Results:At 30, 32, 34 and 36 weeks of gestation, Kim-1, β2-MG and SCr in the observation group increased significantly (Kim-1 Fintra-group=11.234, β2-MG Fintra-group=12.852, SCr Fintra-group=8.308; all P<0.001). In the observation group, SCr(30 weeks, 32 weeks, 34 weeks, 36 weeks (75.35±10.32), (75.41±10.35), (77.02±10.50), (87.78±10.64) μmol/L), Kim-1 (30 weeks, 32 weeks, 34 weeks, 36 weeks (5.68±1.50), (7.56±1.52), (8.25±1.62), (9.65±1.76) ng/L), β2-MG (30 weeks, 32 weeks, 34 weeks, 36 weeks (0.26±0.07), (0.29±0.08), (0.75±0.29), (1.02±0.38) ng/L) were all higher than those of control group SCr(30 weeks, 32 weeks, 34 weeks, 36 weeks (74.37±10.34), (74.43±10.40), (75.10±12.52), (76.80±11.66) μmol/L), Kim-1 (30 weeksL, 32 weeks, 34 weeks, 36 weeks (5.31±1.75), (5.36±1.77), (5.39±1.60), (5.41±1.70) ng/L), β2-MG (30 weeks, 32 weeks, 34 weeks, 36 weeks (0.25±0.07), (0.26±0.09), (0.28±0.08), (0.27±0.08) mg/L), the difference was statistically significant (SCr Fintergroup=10.254, Kim-1 Fintergroup=16.352, β2-MG Fintergroup=18.221; all P<0.001). There were interaction between the two groups at different time(SCr Finteraction=15.632, Kim-1 Finteraction=25.645, β2-MG Finteraction=34.251; all P<0.001). The sensitivity, specificity and accuracy of Kim-1 combined with β2-MG were 96.43% (54/56), 94.64% (53/56) and 95.54% (107/112), respectively.It was significantly better than Kim-1 alone (88.24% (45/51), 92.86% (52/56), 86.61% (97/112)), β2-MG alone (81.13% (43/53), 78.57% (44/56), 77.68% (87/112)), the difference was statistically significant (all P<0.05). Conclusion:The serum levels of KIM-1 and β2-MG in pregnant women with early renal injury of HDP are significantly increased, which can be used as a reliable indicator for prenatal monitoring and screening of early renal injury, and the combined detection can improve the accuracy of diagnosis.