Zhongguo linchuang yanjiu (Feb 2023)

Association of urinary NGAL and early diagnosis and prognosis of IgA nephropathy

  • SHI Jia-jia*, ZHU Guo-zhen

DOI
https://doi.org/10.13429/j.cnki.cjcr.2023.02.022
Journal volume & issue
Vol. 36, no. 2
pp. 266 – 270

Abstract

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Objective To investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in the early diagnosis of IgA nephropathy and its relationship with the cumulative survival rate of kidney in patients with IgA nephropathy. Methods The case group consisted of 39 patients with primary IgA nephropathy diagnosed by renal biopsy in the Second Hospital of Shanxi Medical University from March 2017 to July 2018, and the control group consisted of 55 healthy people in the same period. Patients with IgA nephropathy were divided into mild, moderate and severe groups according to the proportion of renal tubulointerstitial injury area, and into high and low urinary NGAL groups according to the median urine NGAL. The levels of urinary NGAL in each group were compared. To analyze the early diagnostic efficacy of urine NGAL and urine kidney injury molecule-1 (KIM-1) for IgA nephropathy. The correlation between urinary NGAL and various clinical indicators was analyzed. The cumulative survival rate of the kidney was compared among groups with different urinary NGAL levels and groups with different degrees of tubulointerstitial injury. Results There were statistically significant differences in urinary NGAL levels between the case group and the control group, as well as between groups with different degrees of tubulointerstitial injury (P<0.05). ROC curve showed that the area under the curve (AUC=0.809) of urine NGAL for the early diagnosis of IgA nephropathy was larger than that of urine KIM-1 (AUC=0.746). In Spearmans correlation analysis, urine NGAL of IgA nephropathy patients showed a positive correlation with urine KIM-1, N-acetyl-β-D-glucosaminidase (NAG), retinol binding protein (RBP), α1-microglobulin (α1-MG), serum creatinine (SCr) and 24-h urine protein quantitation (P<0.05), and a negative correlation with estimated glomerular filtration rate (eGFR) (P<0.05). Kaplan-Meier survival analysis showed that the cumulative renal survival rate of patients with IgA nephropathy in the urine high level group of NGAL was lower than that in the urine low level group of NGAL (P<0.05), and the cumulative renal survival rate of patients with IgA nephropathy in the severe tubulointerstitial injury group was lower than that in the mild and moderate tubulointerstitial injury groups (P<0.05).Conclusion The detection of urinary NGAL has certain clinical application value in the early diagnosis and prognostic evaluation of IgA nephropathy.

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