Application Of Urinary Biomarkers In Children Kidney Diseases

ObjectiveTo discuss the changes of y-GT,LAP, LDH in urine which appeared in different kidney diseases. To explore that if these indicators can be the monitoring indicators of nephrotic syndrome in activity and remission period or not;To explore the significance of some urinary biomarkers (β-MG、RBP、α1-MG、MA、tFR、NAG、 LAP、γ-GT、LDH and isoenzymes) in the localization diagnosis of children urinary tract infection.MethodsCollect100morning urine specimens from healthy children;179cases hospitalized in our hospital nephrology from1January2013to31December2013were devided into60cases of primary nephrotic syndrome(PNS),40cases of persistent glomerulonephritis (PGN),79cases of urinary tract infection(UTI). To test and analyze the urinary y-GT,LAP, LDH among the healthy control group, PNS group, PGN group and UTI group statistically. To test and analyze the urinary biomarkers (p2-MG、RBP、α1-MG、MA、tFR、NAG、LAP、γ-GT、LDH and isoenzymes) between the34cases of simplex PNS and26cases of nephritis PNS. To test and analyze the urinary y-GT,LAP, LDH between active stage and remission stage of49hormone-sensitive PNS cases.79cases of urinary tract infection were devided into32UUTI cases and47LUTI cases. To test and analyze the urinary biomarkers(P2-MG, RBP、α1-MG、MA、tFR、NAG、LAP、γ-GT、LDH and isoenzymes) between them In order to provide the reference index on the localization diagnosis of urinary tract infection. The10ml specimens were collected at the first morning and send to the laboratory whin one hour.Result1Urinary y-GT, LAP, LDH in PNS group increased significantly, There was significant difference among them (P<0.05).2. Urinary y-GT, LAP, LDH were higher in PNS active stage than in remission stage, There was significant difference between them (P<0.05).3. Urinary β2-MG, RBP, NAG, γ-GT, LDH were higher in UUTI than in LUTI, There was significant difference between them (P<0.05). The change of urinary LDH isozyme spectrum (LDH5> LDH4> LDH3> LDH2> LDH1) appeared in UUTI group, There was significant difference between them (P<0.05).5. Comparisons of urinary β2-MG, RBP, α1-MG, MA, tFR, NAG, LAP, y-GT, LDH between simplex and nephritis PNS were not significantly different (P>0.05).Conclusions1.Urinary y-GT, LAP, LDH in PNS group increased significantly, There was significant difference among them. The remaining differences between the other groups was not significant. In the differential diagnosis of primary glomerular disease merged tubular injury, Urinary y-GT, LAP, LDH can be used as a aid indicator.2. The level of urinary y-GT, LAP, LDH increased in active stage and declined in remission stage, There was significant difference between them.Therefore these indicators can be used as monitoring indicators for NS activity and disease repeated.3.The level of urinary β2-MG、RBP、NAG、γ-GT、LDH is higher in UUTI group than in LUTI group. There was significant difference between them. Therefore, Urinary β2-MG、RBP、NAG、γ-GT, LDH conbined with ESR, WBC, CRP, PCT can be more valuable in the localization diagnosis of urinary tract infection.The change of urinary LDH isozyme spectrum (LDH5> LDH4> LDH3> LDH2> LDH1) appeared in UUTI group,Which can be used as one reference of the localization diagnosis of urinary tract infection.4. There was no difference about urinary (β2-MG、RBP、α1-MG、MA, tFR, NAG, LAP, γ-GT, LDH between simplex and nephritis PNS group, Urinary biomarkers reflect early injure of renal function,There was no reference in the diagnosis of PNS type.