Department of Clinical Laboratory, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.
Appl Spectrosc. 2021 Apr;75(4):412-421. doi: 10.1177/0003702820966322. Epub 2020 Oct 29.
Chronic kidney disease (CKD) affects more than 10% of the global population and is associated with significant morbidity and mortality. In most cases, this disease is developed silently, and it can progress to the end-stage renal failure. Therefore, early detection becomes critical for initiating effective interventions. Routine diagnosis of CKD requires both blood test and urinalyses in a clinical laboratory, which are time-consuming and have low sensitivity and specificity. Surface-enhanced Raman scattering (SERS) is an emerging method for rapidly assessing kidney function or injury. This study was designed to compare the differences between the SERS properties of the serum and urine for easy and simple detection of CKD. Enrolled for this study were 126 CKD patients (Stages 2-5) and 97 healthy individuals. SERS spectra of both the serum and urine samples were acquired using a Raman spectrometer (785 nm excitation). The correlation of chemical parameters of kidney function with the spectra was examined using prinicpal component analysis (PCA) combined with linear discriminant analysis (LDA) and partial least squares (PLS) analysis. Here, we showed that CKD was discriminated from non-CKD controls using PCA-LDA with a sensitivity of 74.6% and a specificity of 93.8% for the serum spectra, and 78.0% and 86.0 % for the urine spectra. The integration area under the receiver operating characteristic curve was 0.937 ± 0.015 ( < 0.0001) for the serum and 0.886 ± 0.025 ( < 0.0001) for the urine. The different stages of CKD were separated with the accuracy of 78.0% and 75.4% by the serum and urine spectra, respectively. PLS prediction (R) of the serum spectra was 0.8540 for the serum urea ( < 0.001), 0.8536 for the serum creatinine ( < 0.001), 0.7500 for the estimated glomerular filtration rate (eGFR) ( < 0.001), whereas the prediction (R) of urine spectra was 0.7335 for the urine urea ( < 0.001), 0.7901 for the urine creatinine ( < 0.001), 0.4644 for the eGFR ( < 0.001) and 0.6579 for the urine microalbumin ( < 0.001). In conclusion, the accuracy of associations between SERS findings of the serum and urine samples with clinical conclusions of CKD diagnosis in this limited number of patients is similar, suggesting that SERS may be used as a rapid and easy-to-use method for early screening of CKD, which however needs further evaluation in a large cohort study.
慢性肾脏病（CKD）影响全球超过 10%的人口，与显著的发病率和死亡率相关。在大多数情况下，这种疾病是无声无息发展的，它可以进展为终末期肾衰竭。因此，早期发现对于开始有效的干预至关重要。CKD 的常规诊断需要在临床实验室进行血液测试和尿液分析，这既耗时又具有低敏感性和特异性。表面增强拉曼散射（SERS）是一种用于快速评估肾功能或损伤的新兴方法。本研究旨在比较血清和尿液的 SERS 特性之间的差异，以实现 CKD 的简便检测。本研究纳入了 126 名 CKD 患者（2-5 期）和 97 名健康个体。使用拉曼光谱仪（785nm 激发）获得血清和尿液样本的 SERS 光谱。使用主成分分析（PCA）结合线性判别分析（LDA）和偏最小二乘（PLS）分析，检查肾功能的化学参数与光谱之间的相关性。在这里，我们使用 PCA-LDA 显示 CKD 与非 CKD 对照的区分，血清谱的灵敏度为 74.6%，特异性为 93.8%，尿液谱的灵敏度为 78.0%，特异性为 86.0%。血清和尿液的受试者工作特征曲线下面积分别为 0.937±0.015（ < 0.0001）和 0.886±0.025（ < 0.0001）。血清和尿液谱分别以 78.0%和 75.4%的准确率分离不同阶段的 CKD。血清谱的 PLS 预测（R）分别为血清尿素（ < 0.001）0.8540、血清肌酐（ < 0.001）0.8536、估计肾小球滤过率（eGFR）（ < 0.001）0.7500，而尿液谱的预测（R）分别为尿液尿素（ < 0.001）0.7335、尿液肌酐（ < 0.001）0.7901、eGFR（ < 0.001）0.4644和尿液微量白蛋白（ < 0.001）0.6579。总之，在这个有限数量的患者中，血清和尿液样本的 SERS 发现与 CKD 诊断的临床结论之间的关联的准确性相似，这表明 SERS 可作为 CKD 早期筛查的快速易用方法，但需要在更大的队列研究中进一步评估。
