Department of Nephrology, County Emergency Hospital, 'Victor Babes' University of Medicine and Pharmacy , Timisoara , Romania and.
Ren Fail. 2013;35(10):1358-64. doi: 10.3109/0886022X.2013.828367. Epub 2013 Sep 2.
The solitary kidney (SK) is currently debated in the literature, as living kidney donation is extensively used and the diagnosis of congenital SK is frequent. Tubulointerstitial lesions associated with adaptive phenomena may occur early within the SK.
Analysis of the significance of urinary biomarkers in the assessment of tubulointerstitial lesions of the SK.
A cross-sectional study of 37 patients with SK included 18 patients-acquired SK (mean age 56.44 ± 12.20 years, interval from nephrectomy 10.94 ± 9.37 years), 19 patients-congenital SK (mean age 41.52 ± 10.54 years). Urinary NAG, urinary alpha-1-microglobulin, albuminuria, eGFR (CKD-EPI equation) were measured.
In acquired SK, NAG increased in 60.66%, urinary alpha 1-microglobulin in 16.66%, albuminuria in 55.55% of patients. Inverse correlation with eGFR presented NAG (R(2 )= 0.537, p = 0.022), urinary alpha 1-microglobulin (R(2 )= 0.702, p = 0.001), albuminuria (R(2 )= 0.655, p = 0.003). In congenital SK, NAG increased in 52.63%, urinary alpha 1-microglobulin in 5.26%, albuminuria in 47.36% of patients. In this group, urinary biomarkers correlated inversely with eGFR: NAG (R(2 )= 0.743, p < 0.001), urinary alpha 1-microglobulin (R(2 )= 0.701, p = 0.001), albuminuria (R(2 )= 0.821, p < 0.001). Significant correlations were found between the urinary biomarkers in both groups.
Urinary biomarkers allow a non-invasive, sensitive, early assessment of the tubular lesions of the SK. Urinary biomarkers of PT injury parallel renal function decline, thus complementing the estimation of GFR. Monitoring of PT dysfunction is mandatory in patients with SK.
孤立肾（SK）目前在文献中存在争议，因为活体肾脏捐献广泛应用，先天性 SK 的诊断也很常见。与适应性现象相关的肾小管间质病变可能在 SK 早期发生。
分析尿生物标志物在评估 SK 肾小管间质病变中的意义。
对 37 例 SK 患者进行横断面研究，其中 18 例为获得性 SK（平均年龄 56.44±12.20 岁，肾切除术后间隔 10.94±9.37 年），19 例为先天性 SK（平均年龄 41.52±10.54 岁）。测量尿 NAG、尿α1-微球蛋白、蛋白尿、eGFR（CKD-EPI 方程）。
在获得性 SK 中，60.66%的患者 NAG 升高，16.66%的患者尿α1-微球蛋白升高，55.55%的患者蛋白尿升高。NAG 与 eGFR 呈负相关（R²=0.537，p=0.022），尿α1-微球蛋白（R²=0.702，p=0.001），蛋白尿（R²=0.655，p=0.003）。在先天性 SK 中，52.63%的患者 NAG 升高，5.26%的患者尿α1-微球蛋白升高，47.36%的患者蛋白尿升高。在这一组中，尿生物标志物与 eGFR 呈负相关：NAG（R²=0.743，p<0.001），尿α1-微球蛋白（R²=0.701，p=0.001），蛋白尿（R²=0.821，p<0.001）。两组间尿生物标志物存在显著相关性。
尿生物标志物可实现对 SK 肾小管损伤的非侵入性、敏感、早期评估。PT 损伤的尿生物标志物与肾功能下降平行，因此补充了 GFR 的估计。对 SK 患者进行 PT 功能障碍监测是必要的。
