To Investigate The Correlation Between Urinary Level Of NGAL And Tubulointerstitial Lesions In Patients With Primary Nephrotic Syndrome

Objective:To investigate the correlation between urinary level ofneutrophil gelatinase-associated lipocalin（NGAL）and tubulointerstitial lesions in invalids with primary nephrotic syndrome（PNS）.Methods:Urine NGAL of 81 patients with PNS undergoing renal biopsy and 60 healthy volunteers from March 2017 to July 2018 were analyzed.Clinical data of all patients were collected,and urine NGAL tests were performed on all subjects.The patients with PNS included MCD,MGN,FSGS,MSPGN and MPGN according to the classification criteria of glomerular diseases.According to the the standard of tubulointerstitial lesions,the patients were divided into mild,moderate and severe group.The urine NGAL standard of different groups were compared,the connection between urinary NGAL and the degree of tubulointerstitial lesions in patients with PNS was investigated,and the correlations among urinary NGAL and various clinical indicators were analyzed.Results:1.The standard of urinary NGAL in the observation group was higher compared with healthy population（（39.37±29.33）ng/ml vs.（9.77±8.15）ng/ml）（t=8.646,P<0.05）.2.In patients with PNS,the differences in tubulointerstitial lesion scores（（1.60±0.74）vs.（1.55±0.74）vs.（2.33±0.66）vs.（2.22±0.83）vs.（2.29±0.76））,urine NGAL（（24.63±21.36）ng/ml vs.（24.57±22.73）ng/ml vs.（51.59±28.69）ng/ml vs.（61.03±28.85）ng/ml vs.（67.66±19.49）ng/ml）among groups of MCD,MGN,FSGS,MSPGN and MPGN were statistically significant（F=5.070,9.271,P<0.05）.The differences in urine NGAL（（18.92±12.14）ng/ml vs.（43.13±22.23）ng/ml vs.（70.94±22.67）ng/ml）among groups of mild,moderate,and severe were statistically significant（F=46.475,P<0.05）.3.The area under the ROC curve of urine NGAL（AUC=0.847）for the diagnosis of tubulointerstitial lesions in invalids which was higher compared with RBP,α₁-MG and NAG（AUC=0.81,0.746,0.723）.4.The urinary NGAL was positively correlated with RBP,α₁-MG,NAG,Scr,BUN,and 24h urinary protein excretion（r value was 0.399,0.360,0.493,0.461,0.422,0.348individually,P<0.05）,and was inversely correlated with eGFR（r value was-0.364,P<0.05）.Conclusion:Urinary level of NGAL is associated with the degree of tubulointerstitial lesions in patients with PNS,which provides some predicting value for the prognosis of these diseases.