Lorenzo-Gómez María-Fernanda, Flores-Fraile María-Carmen, Márquez-Sánchez Magaly, Flores-Fraile Javier, González-Casado Ignacio, Padilla-Fernández Bárbara, Valverde-Martínez Sebastián, Hernández Sánchez Teresa, Muller-Arteaga Carlos, García-Cenador María-Begoña
Department of Surgery, University of Salamanca, Salamanca, Spain Multidisciplinary Renal Research Group) of the Institute for Biomedical Research of Salamanca (IBSAL), Spain Urology Service of the University Hospital of Salamanca, Salamanca, Spain.
Department of Surgery, University of Salamanca, Salamanca, Spain.
Ther Adv Urol. 2020 Dec 7;12:1756287220974133. doi: 10.1177/1756287220974133. eCollection 2020 Jan-Dec.
To characterize the impact on kidney injury of recurrent urinary tract infections (RUTI) in the frail elderly.
Prospective observational study in 200 frail elderly subjects for 1 year. Groups: GA ( = 100): subjects without RUTI, GB ( = 100): subjects with RUTI. Variables: age, concomitant diseases, glomerular filtration rate (GFR), urine neutrophil gelatinase-associated lipocalin (NGAL) at the beginning (NGAL-1) and end (NGAL-2) of the study, urine N-acetyl glucosaminidase (NAG) at the beginning (NAG-1) and the end (NAG-2) of the study, urine transforming growth factor-beta 1 (TGFβ-1). Descriptive statistics, Mann-Whitney test, Chi-squared test, Fisher's exact test, and multivariate analysis were used.
Mean age was 84.33 (65-99) years old, with no difference between GA and GB. Mean NGAL-1 was 1.29 ng/ml (0.04-8). There was lower in GA than in GB. Mean NGAL-2 was 1.41 ng/ml (0.02-9.22). NGAL-2 was lower in GA than in GB. Mean NAG-1 was 0.38 UU.II/ml (0.01-2.63. NAG-1 in GA was lower than in GB. Mean NAG-2 was 0.44 UU.II/ml (0-3.41). NAG-2 was lower in GA compared with GB. Mean TGFβ-1 was 23.43 pg/ml (0.02-103.76). TGFβ-1 was lower in GA than GB. There were no differences in the presence of secondary diagnoses between GA and GB. NAG-2 and NGAL-1 were the most determining factors of renal function; in GA it was NGAL-2, followed by NAG-1; in GB it was NGAL-1, followed by NAG-2.
Frail elderly with RUTI have higher urinary levels of renal injury markers, specifically NGAL, NAG, and TGFβ-1, chronically in periods between urinary tract infection (UTI). Urinary markers of renal injury, specifically NGAL, NAG, and TGFβ-1, identify early deterioration of renal function, compared with serum creatinine, or albuminuria, in frail elderly with recurrent urinary infections.
探讨复发性尿路感染（RUTI）对体弱老年人肾损伤的影响。
对200名体弱老年人进行为期1年的前瞻性观察研究。分组：GA组（n = 100）：无复发性尿路感染的受试者；GB组（n = 100）：有复发性尿路感染的受试者。变量：年龄、合并疾病、肾小球滤过率（GFR）、研究开始时（NGAL-1）和结束时（NGAL-2）的尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、研究开始时（NAG-1）和结束时（NAG-2）的尿N-乙酰氨基葡萄糖苷酶（NAG）、尿转化生长因子-β1（TGFβ-1）。采用描述性统计、曼-惠特尼检验、卡方检验、费舍尔精确检验和多变量分析。
平均年龄为84.33（65 - 99）岁，GA组和GB组之间无差异。平均NGAL-1为1.29 ng/ml（0.04 - 8）。GA组低于GB组。平均NGAL-2为1.41 ng/ml（0.02 - 9.22）。GA组的NGAL-2低于GB组。平均NAG-1为0.38 UU.II/ml（0.01 - 2.63）。GA组的NAG-1低于GB组。平均NAG-2为0.44 UU.II/ml（0 - 3.41）。与GB组相比，GA组的NAG-2较低。平均TGFβ-1为23.43 pg/ml（0.02 - 103.76）。GA组的TGFβ-1低于GB组。GA组和GB组在继发性诊断方面无差异。NAG-2和NGAL-1是肾功能的最主要决定因素；在GA组中是NGAL-2，其次是NAG-1；在GB组中是NGAL-1，其次是NAG-2。
患有复发性尿路感染的体弱老年人在尿路感染（UTI）间歇期，其尿液中肾损伤标志物（特别是NGAL、NAG和TGFβ-1）水平长期较高。与血清肌酐或蛋白尿相比，肾损伤的尿液标志物（特别是NGAL、NAG和TGFβ-1）可识别复发性尿路感染体弱老年人肾功能的早期恶化。
