Effect Of Serum Uric Acid Level On Urine KIM-1,NGAL And β2-MG Production In Patients With Renal Calculi

Objective: To study the effect of serum uric acid level on the production of kidney injury molecule-1(KIM-1),neutrophil getatinase-associated lipocalin(NGAL)and β2microglobulin(β2-MG)in urine of patients with renal calculi.To explore the mechanism of renal injury induced by hyperuricemia in stone formation.Further elucidating the pathogenesis of renal calculi.At the same time looking for effective monitoring of the risk of stone formation and evaluation of the clinical efficacy of the means.It also provides a new idea for the prevention and treatment of renal calculi and clinical drug research.Methods: 61 cases of renal calculi hospitalized in department of urology,affiliated hospital of youjiang medical university for nationalities were selected according to the principle of randomized control.The data of general cases were collected.Peripheral venous blood samples were collected for routine and biochemical examination.The white blood cell count(WBC),uric acid(UA)and,serum creatinine(SCR),alanine transaminase(ALT),fasting blood glucose(FPG),urea nitrogen(UREA),glomerular filtration rate(GFR),cystatin-C(Cys-C)and others was measured.Then,according to the level of serum uric acid,30 patients with HUA were included in the high uric acid stone group,31 non-HUA patients were included in the low uric acid stone group,and 27 healthy persons were randomly selected as the control group.The contents of KIM-1,NGAL and β2-MG in urine were determined by enzyme-linked immunosorbent assay(Elisa)in three groups of urine.Results:(1)30 patients with HUA divided into hight uric acid stone group(group H),including 20 male patients and 10 female patients.The average age of the group H was(48.6±12.2)years old.31 patients with non-HUA were divided into low uric acid stone group(group L).There were 13 male patients and 18 female patients in this group.The average age of the group L was(45.6±10.6)years old.At the same time,27 healthy controls were divided into control group(group C),which included 17 males and 10 females.The average age of the group C was(42.8±11.5).(2)There was no significant difference in AGE,SEX,BMI,WBC,SCR,ALT,FPG,UREA,GFR and Cys-C among the three groups(P>0.05).(3)The contents of KIM-1 in group H,group L and group C were 3.31(0.58,0.14)pg/ml,0.31(0.17,0.80)pg/ml,0.69(0.33,1.86)pg/ml.Compared with the other two groups,KIM-1 production in urine of group H was increased(P<0.01).There was no significant difference in urine KIM-1production between group L and group C(P>0.05).The content of NGAL in group H,group L and group C was 3.78(2.70,5.04)nmol/ml,3.10(1.24,4.00)nmol/ml,2.40(0.81,3.05)nmol/ml.NGAL production in urine of group H was higher than that of group L and group C(P<0.01).There was no significant difference in urine NGAL production between group L and group C(P>0.05).β2-MG production in urine of group H,group L and group C were(1170.31±733.33)nmol/ml,(1041.85±726.20)nmol/ml,(1194.00±536.58)nmol/ml,There was no significant difference in content expression among the three groups(P>0.05).(4)Pearson rank correlation analysis showed that there was a significant positive correlation between serum uric acid level and urinary KIM-1 level(r=0.559,P<0.01).There was a positive correlation between serum uric acid level and urinary NGAL level(r=0.216,P<0.05).There was no correlation between serum uric acid level and β2-MG production(r=0.136,P>0.05).Conclusion: High uric acid level can promote the increase of urine KIM-1,NGAL production in patients with renal calculi,suggesting that high uric acid can cause renal injury and is closely related to the formation of renal calculi.High uric acid level had no significant effect on urine β2-MG production.The change of urine β2-MG could not effectively predict the risk of HUA related renal calculi formation.The level of serum uric acid is positively correlated with the content of urine KIM-1,NGAL in patients with renal calculi,suggested that the higher the uric acid in HUA patients,the more serious the degree of renal injury,and it is easy to promote the production of renal calculi.Monitoring the level of serum uric acid can provide help for the prevention and treatment of all kinds of renal calculi.