Chebotareva N V, Bobkova I N, Kozlovskaia L V, Tsopanova Z G
Ter Arkh. 2011;83(6):18-23.
To evaluate severity of nephrinuria (NU) as a marker of podocyte dysfunction (PD) in patients with proteinuric forms of chronic glomerulonephritis (CGN) and to specify efficacy of this test for assessment of activity and prognosis of CGN.
We examined 74 CGN patients: 18 with inactive nephritis (group 1), 18--with subnephrotic proteinuria (group 2), 38--with nephrotic syndrome--NS (group 3). The control group consisted of 10 healthy subjects. Urinary excretion of nephrin was studied with indirect enzyme immunoassay. A response to immunosuppressive treatment (IST) was studied in 23 NS patients depending on a baseline NU level.
An NU level was higher in patients with proteinuric forms of CGN (groups 2 and 3) than in inactive disease and in healthy subjects, in NS patients significantly higher than in less severe proteinuria. NU was significantly higher in arterial hypertension, in persistent NS. Remission of NS was achieved within 6 months of treatment in 9 of 11 (82%) patients with a baseline NU level < 17 ng/ml. Eight from 12 (67%) patients with high NU did not respond to IST conducted for 9 months to 2 years. ROC-curve construction showed that NU assessment in NS patients has high informative value in assessment of prognosis and efficacy of treatment in 6 months to come.
The NU test in CGN patients is an informative diagnostic test allowing prognosis of a response to IST and assessment of PD severity.
评估肾损伤分子-1尿排泄量（NU）作为慢性肾小球肾炎（CGN）蛋白尿型患者足细胞功能障碍（PD）标志物的严重程度，并明确该检测对评估CGN活动度和预后的有效性。
我们检查了74例CGN患者：18例为非活动性肾炎患者（第1组），18例为亚肾病性蛋白尿患者（第2组），38例为肾病综合征（NS）患者（第3组）。对照组由10名健康受试者组成。采用间接酶免疫分析法研究肾损伤分子-1的尿排泄情况。根据基线NU水平，对23例NS患者的免疫抑制治疗（IST）反应进行了研究。
CGN蛋白尿型患者（第2组和第3组）的NU水平高于非活动性疾病患者和健康受试者，NS患者的NU水平显著高于蛋白尿程度较轻的患者。在动脉高血压、持续性NS患者中，NU显著更高。基线NU水平<17 ng/ml的11例患者中有9例（82%）在治疗6个月内实现了NS缓解。12例NU水平高的患者中有8例（67%）对长达9个月至2年的IST无反应。ROC曲线构建显示，NS患者的NU评估对未来6个月的预后和治疗效果评估具有较高的信息价值。
CGN患者的NU检测是一种有价值的诊断检测，可预测对IST的反应并评估PD严重程度。
