Correlation Between The Serum And Urine Level Of Ulinastatin And Renal Fibrosis In Patients With Chronic Kidney Disease

Objective:By detecting the correlation indexes of Ulinastatin(UTI)in serum and urine of patients with chronic kidney disease(CKD)and renal firbosis(TGF-β1,α-SMA,Smad2/3),analyze the correlation between them,explore the clinical significance of UTI in serum and urine with CKD patients and its correlation with TGF-β1/Smads signaling pathway,and provide new ideas for the clinical prevention and treatment of renal firbosis.Methods:The 78 patients who are diagnosed with CKD with renal biopsy for the first time in the Nephrology Department of the First Hospital of Jilin University from May 2019 to December 2019 were selected as the research object,and were divided into T0(mild fibrosis),T1(moderate fibrosis)and T2(severe fibrosis)groups according to the renal interstitial fibrosis/tubular atrophy.At the same time,20 randomly selected people who received health examinations in our hospital during the same period were selected as the control group.We collected general clinical data and laboratory related examination data of each patient.ELISA was used to determine UTI,TGF-β1,α-SMA and Smad2/3 which were analyzed to explore the correlation between UTI and TGF-β1/Smads in patients with CKD.Results:(1)According to the degree of renal interstitial fibrosis / tubular atrophy,78 CKD patients were further divided into three groups: T0(mild fibrosis),T1(moderate fibrosis),and T2(severe fibrosis).There were 29 patients in T0 group,18 males and 11 females,with an average age of 46.55 ± 14.59 years.There were 36 patients in T1 group,19 males and 17 females,with an average age of 47.55 ± 14.32 years.There were 13 patients in the T2 group,8 males and 5 females,with an average age of 49.15 ± 13.77 years.There were 20 normal controls,10 males and 10 females,with an average age of 38.00 ± 8.12 years.There were no statistically significant differences in age,gender,and body mass index between groups(P>0.05).(2)Compared with the normal control group,the level of eGFR in CKD patients was significantly reduced,and the levels of Scr and BUN in T1 and T2 groups were significantly increased,and the difference was statistically significant(P<0.05).Quantitative levels of 24-hour urine protein and 24-hour urine microalbumin were significantly increased in CKD patients.(3)Compared with the normal control group,the levels of TGF-β1,Smad2/3,and α-SMA in serum and urine of CKD patients were significantly increased,and the difference was statistically significant(P <0.05).With the increase of the degree of renal firbosis,the levels of TGF-β1 and α-SMA in serum and urine gradually increased,the difference was statistically significant(P<0.05).(4)Compared with the normal control group,the serum UTI levels of all CKD patients increased,and the difference was statistically significant(P<0.05).With the increase of the UTI level in serum gradually increased,the difference was statistically significant(P <0.05).(5)Serum UTI content was weakly negatively correlated with eGFR,positively correlated with urine TGF-β1,Smad2,α-SMA as well as serum α-SMA,and had no significant correlation with other indicators.Conclusion:(1)Serum UTI was positively correlated with renal firbosis in CKD patients.(2)Serum UTI levels in CKD patients were positively correlated with urine TGF-β1,Smad2,α-SMA,and serum α-SMA levels.(3)UTI in the serum of CKD patients may inhibit renal firbosis through TGF-β1/Smads signaling pathway.