Liu Lizhi, Gu Meifeng, Liu Jia, Liu Qing, Xu Xiaofeng, Fan Rong, Peng Fuhua, Jiang Ying
Department of Neurology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Neurology, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, China.
Front Neurol. 2021 Feb 12;12:601495. doi: 10.3389/fneur.2021.601495. eCollection 2021.
The function of the N-methyl-D-aspartate receptor (NMDAR) in the kidney has been studied. However, the effect on the kidney from anti-NAMDAR antibody encephalitis has not been investigated thus far. Case data were collected from 82 patients with anti-NMDAR antibody encephalitis and 166 age- and sex-matched healthy controls (HCs). Clinical characteristics, urinalysis [including urine pH and urine specific gravity (SG)], serum creatinine (Scr), and estimated glomerular filtration rate (eGFR) based on Cr levels were evaluated. At initial admission, urine pH levels and urine SG levels in anti-NMDAR antibody encephalitis patients were significantly higher and lower, respectively, than HCs (both < 0.001). There were no significant differences in Scr and eGFR between anti-NMDAR antibody encephalitis patients and HCs. Urine pH levels in patients with anti-NMDAR antibody <1:32 were significantly lower than those in patients with anti-NMDAR antibody ≥1:32 ( = 0.029). Urine pH levels were significantly lower ( = 0.004) and urine SG levels were significantly higher ( = 0.027) in a follow-up evaluation 3 months after treatment. The changes in urinalysis occur in patients with anti-NMDAR antibody encephalitis. The pathophysiological changes in anti-NMDAR antibody encephalitis were not limited to the CNS.
N-甲基-D-天冬氨酸受体（NMDAR）在肾脏中的功能已得到研究。然而，抗NMDAR抗体脑炎对肾脏的影响迄今尚未得到研究。收集了82例抗NMDAR抗体脑炎患者和166例年龄及性别匹配的健康对照者（HCs）的病例数据。评估了临床特征、尿液分析[包括尿液pH值和尿比重（SG）]、血清肌酐（Scr）以及基于Cr水平的估算肾小球滤过率（eGFR）。在初次入院时，抗NMDAR抗体脑炎患者的尿液pH值水平显著高于HCs，而尿比重水平则显著低于HCs（均P<0.001）。抗NMDAR抗体脑炎患者与HCs之间的Scr和eGFR无显著差异。抗NMDAR抗体<1:32的患者尿液pH值水平显著低于抗NMDAR抗体≥1:32的患者（P=0.029）。治疗后3个月的随访评估中，尿液pH值水平显著降低（P=0.004），尿比重水平显著升高（P=0.027）。抗NMDAR抗体脑炎患者会出现尿液分析的变化。抗NMDAR抗体脑炎的病理生理变化并不局限于中枢神经系统。
