Diagnostic Value Of Urinary Micro Protein Determination In Lupus Nephritis And Its Related Factors

ObjectiveThrough the detection of lupus nephritis (lupus nephritis, LN) in patients with urinary micro protein (including urine trace albumin, transferrin, IgG, morning urine protein levels, evaluation of urine protein as diagnosis with lupus nephritis and assess the value of the level of proteinuria, and to explore related factors.Methodsa retrospective analysis on June6,2011-February2013the second hospital affiliated to zhe jiang university school of medicine FengShiKe LN patients, the general clinical information collection, blood biochemical indicators,24h urine protein levels, semi-quantitative and trace the morning urine protein urine protein levels. Analysis urine micro protein quantitative level as the specificity, sensitivity, diagnosed with lupus nephritis and assess different urinary micro protein detection index and24hours urinary protein quantitatively, the consistency between the consistency of its relevant factors, and analyze the different combination of detection efficiency. Results1. LN patients enrolled in the study of382cases,22cases of men, women,360cases, with an average age of31+/-10.95years of age, course of9+/-7.71years on average. The morning urine protein and the24h urine protein in patients with quantitative was significantly positively related to (rho=0.740, P<0.001); In24h urine protein quantitative500mg or more, the corresponding morning urine protein area under the ROC curve is0.850, the corresponding diagnosis boundary values for the morning urine protein p+2, its diagnostic sensitivity and specificity were69.1%and90.3%respectively, positive likelihood ratio is7.1, the negative quasi likelihood ratio is0.3; With morning urine protein1+positive point or judgment with lupus nephritis of false positive rate was44.6%, false negative rate was10.8%, compared with the24h urine protein quantitative differences are significant (McNemar’s test, P<0.001), the test of two kinds of kappa=0.452predominate;2. urine micro protein (including urine trace albumin, transferrin and IgG) and24h urine protein quantitative correlation (rho=0.832,0.832,0.839, P<0.001),4h urine protein quantitative500mg or more corresponding urine trace albumin and transferrin area under the ROC curve were greater than0.9, the urine trace albumin, urinary transferrin, the cutoff value of urine IgG were289.1mg,25.8mg/right/right r r,37.8mg/right r and24hours urinary protein quantitative consistency respectively kappa=0.692predominate, kappa=0.704predominate, kappa=0.634predominate.3.the urine trace albumin, transferrin and urine routine urine protein, IgG semi-quantitative detection in series (two, three or four) can significantly reduce the false positive rate of detection, but ShiJia negative rate is greatly increased, and the consistency of the24h urine protein quantitative detection (kappa values predominate) are less than0.700; And the urine trace albumin and urinary transferrin in parallel and urinary transferrin and IgG parallel detection of both false positive and false negative rate is not high, and with24hr urine protein quantitative detection of consistency (kappa values predominate) were greater than0.700;4. with500mg/24hr,289.1mg/gCr as positive point, the consistency of the results or not as independent variables, examine the related variables. Serum albumin was found on Logistic regression (B=0.130, chi-square=0.130, P=0.002), serum creatinine (B=0.008, chi-square=0.008, P=0.045), serum low density lipoprotein (B=0.495, chi-square=0.495, P=0.046), urinary transferrin (B=0.024, chi-square=0.024, P=0.010) associated with the consistency of the results.With500mg/24hr,25.8mg/gCr as positive point, the two results of consistency or not as independent variables, inspects the related variables. Serum albumin was found on Logistic regression (B=0.067, chi-square=0.067, P=0.021), routine urine pH (B=0.963, chi-square=0.963, P=0.002), serum IgG (B=0.010, chi-square=0.010, P=0.003) associated with the consistency of the results.With500mg/24hr,37.8mg/gCr as positive point, the two results of the consistency or not as independent variables, inspects the related variables. After Logistic regression found that the routine urine pH (B=0.818, chi-square=0.818, P=0.007), urinary transferrin (B=0.012, chi-square=0.012, P=0.006) associated with the consistency of the results.With500mg/24hr,2+24hr urine protein as a positive point, the consistency of the results or not as independent variables, examine the related variables. Serum albumin was found on Logistic regression (B=0.050, chi-square=0.050, P=0.054), urinary transferrin (B=0.007, chi-square=0.007,P=0.002) associated with the consistency of the results. Conclusions1. semi-quantitative morning routine urine protein, the value of diagnosis and monitoring the level of proteinuria with lupus nephritis is limited, the diagnosis of the error rate is higher.2. the urine trace albumin, transferrin and IgG is the level of proteinuria sensitive reaction with lupus nephritis patients and relatively specific indicators, two parallel to the value of diagnosis with lupus nephritis.3.24hr urine protein, urine micro protein detection and quantitative results by the consistency of the serum albumin, serum creatinine, blood low density lipoprotein cholesterol (hdl-c), blood IgG levels and the influence of such factors as routine urine pH value.