Fedak Danuta, Kuźniewski Marek, Fugiel Andrzej, Wieczorek-Surdacka Ewa, Przepiórkowska-Hoyer Bernadetta, Jasik Piotr, Miarka Przemysław, Dumnicka Paulina, Kapusta Maria, Solnica Bogdan, Sułowicz Władysław
Pol Arch Med Wewn. 2016 Dec 5;126(12):995-1004. doi: 10.20452/pamw.3712.
INTRODUCTION Urinary uromodulin excretion has been associated with kidney diseases. However, serum uromodulin concentrations have not been extensively studied in patients with chronic kidney disease (CKD), and the results of published studies are inconsistent. OBJECTIVES The aims of the study were to evaluate serum uromodulin concentrations in patients with CKD and to assess the utility of serum uromodulin measurements for diagnosing CKD stages. PATIENTS AND METHODS This observational study included 170 patients with CKD stages 1 to 5, not treated by renal replacement therapy, and 30 healthy individuals. The serum levels of creatinine, cystatin C, and uromodulin were measured, and estimated glomerular filtration rate (eGFR) was calculated according to the 2012 CKD Epidemiology Collaboration cystatin‑creatinine equation. RESULTS Among patients with CKD, serum uromodulin concentrations were significantly lower than in controls, and were strongly negatively correlated with renal retention markers (ie, serum creatinine and cystatin C) and strongly positively correlated with eGFR. An inverse, hyperbolic relationship between serum creatinine and uromodulin levels was analogous to the well‑known association between serum creatinine concentrations and eGFR. A receiver‑operating characteristic curve analysis showed a high diagnostic accuracy of the measurement of serum uromodulin concentrations in the assessment of CKD stages. CONCLUSIONS Serum uromodulin concentrations are closely correlated with eGFR, which is the recommended measure of renal function. As uromodulin is produced exclusively by renal tubular cells, the assessment of uromodulin levels in patients with CKD may be an alternative method for evaluating the number of functioning nephrons.
尿调节素排泄与肾脏疾病相关。然而，慢性肾脏病（CKD）患者的血清尿调节素浓度尚未得到广泛研究，且已发表研究的结果并不一致。
本研究旨在评估CKD患者的血清尿调节素浓度，并评估血清尿调节素检测在诊断CKD分期中的实用性。
这项观察性研究纳入了170例1至5期未经肾脏替代治疗的CKD患者和30名健康个体。检测血清肌酐、胱抑素C和尿调节素水平，并根据2012年CKD流行病学协作组的胱抑素 - 肌酐方程计算估算肾小球滤过率（eGFR）。
在CKD患者中，血清尿调节素浓度显著低于对照组，且与肾脏潴留标志物（即血清肌酐和胱抑素C）呈强负相关，与eGFR呈强正相关。血清肌酐与尿调节素水平之间的反比双曲线关系类似于血清肌酐浓度与eGFR之间的已知关联。受试者工作特征曲线分析显示，血清尿调节素浓度检测在评估CKD分期中具有较高的诊断准确性。
血清尿调节素浓度与eGFR密切相关，eGFR是推荐的肾功能测量指标。由于尿调节素仅由肾小管细胞产生，评估CKD患者的尿调节素水平可能是评估功能性肾单位数量的一种替代方法。
