| BackgroundIn recent years,the incidence of global kidney disease has been increasing,early diagnosis and treatment of various primary and secondary kidney diseases has become a research hotspot.At present,some biomarkers for the diagnosis of kidney diseases have certain limitations in clinical practice due to many external factors.Human epididymis protein 4(HE4)is an extracellular secreted protein.In 2013,LeBleu et al.found that it indirectly inhibited the degradation of type I collagen and promoted renal fibrosis.In the kidney tissue,the expression of HE4 protein was significantly increased.In recent years,some studies have shown that serum HE4 levels are elevated in patients with kidney disease,suggesting that HE4 may be a potential biomarker for the diagnosis of kidney-related diseases.At present there are few reports about the expression of HE4 in clinical common kidney diseases such as idiopathic membranous nephropathy,IgA nephropathy,diabetic nephropathy and acute kidney injury,etc.ObjectiveIn order to provide strong evidence for the diagnosis and treatment of kidney disease,we detect the expression of HE4 in patients with IMN,IgAN,DN and AKI,as well as analyzing its correlation with clinical indicators of kidney disease.MethodsWe observed 73 inpatients in the Department of Nephrology,Qilu Hospital of Shandong University from 2017 to 2019(27 cases of IgAN,34 cases of IMN and 12 cases of DN diagnosed by renal biopsy)and 3 inpatients of endocrinology(clinical diagnosis of DN).Patients' serum were collected,as well as the serum of patients diagnosed as AKI(n=16 cases)in the inpatients of Qilu Hospital of Shandong University.The clinical data of these patients were collected and collated,including age,sex,serum albumin,phospholipase A2 receptor antibody,erythrocyte sedimentation rate,urinary total protein creatinine ratio,urinary albumin creatinine ratio,hemoglobin,serum creatinine,calcium,phosphorus,urea nitrogen,glomerular filtration rate.21 normal subjects who underwent physical examination at Qilu Hospital of Shandong University in 2018 were selected as healthy controls.SPSS 22.0 software was used for statistical comparison and analysis.Results1.The HE4 level in IMN group,IgAN group,DN group and AKI group was higher than those in healthy control group.2.HE4 level of IMN group was significantly different from DN group and AKI group;HE4 level of IgAN group was significantly different from DN group and AKI group;HE4 level was significantly different between DN group and AKI group.3.Spearman correlation analysis showed that the HE4 level in IMN patients was positively correlated with Cys-C,UAcr,UTcr and Scr levels,negatively correlated with GFR level and had no significant correlation with PLA2R antibody,BUN,HGB,ALB,and age(P<0.05).4.In IMN group with normal GFR,HE4 levels were increased(P<0.05).5.In IMN group,ROC showed that the sensitivity,specificity and truncation value of serum HE4 were 77.8.?83.7 and 49.1 pg/ml respectively.6.Spearman correlation analysis showed that in IgAN patients serum HE4 level was positively correlated with Scr level,negatively correlated with GFR level,and not correlated with UTcr,UAcr,Cys-C,BUN,HGB,ALB and age(P<0.05).7.Spearman correlation analysis showed that serum in DN patients HE4 level was positively correlated with BUN and Cys-C levels,negatively correlated with UAcr,and not correlated with UTcr,Scr,GFR,HGB,ALB and age(P<0.05).8.Spearman correlation analysis showed that in AKI patients serum HE4 levels were negatively correlated with GFR levels,and were not associated with UTcr,UAcr,Scr,Cys-C,BUN,HGB,ALB,and age(P<0.05).9.Spearman correlation analysis showed that in primary and secondary kidney disease HE4 expression was positively correlated with Scr,BUN and Cys-C,and negatively correlated with HGB level(P<0.05).Conclusions1.The serum HE4 concentration of IMN patients was increased,and was positively correlated with Scr,UTcr,Cys-C and UAcr levels,negatively correlated with GFR,and independent of BUN,HGB and age.It may become a diagnostic index of IMN by detecting HE4.2.The serum HE4 concentration in patients with IgA nephropathy was increased,and it was positively correlated with Scr level,negatively correlated with GFR level,and not correlated with UTcr,UAcr,Cys-C,BUN HGB and age.3.The serum HE4 concentration in patients with diabetic nephropathy was increased,and it was positively correlated with BUN and Cys-C levels,negatively correlated with UAcr,and not correlated with UTcr,Scr,GFR,HGB and age.4.The serum HE4 concentration in AKI patients was increased,and it was negatively correlated with GFR level,and was not correlated with UTcr,UAcr,Scr,Cys-C,BUN,HGB and age.5.In general,in patients with primary and secondary kidney disease,the serum HE4 levels are related to SCr,BUN,Cys-C and HGB,and are not related to UTcr,UAcr,GFR and age. |
PDF Full Text Request