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抗N-甲基-D-天冬氨酸受体抗体脑炎患者的肾脏影响

The Effect on the Kidney in Patients With Anti-N-methyl D-aspartate Receptor Antibody Encephalitis.

作者信息

Liu Lizhi, Gu Meifeng, Liu Jia, Liu Qing, Xu Xiaofeng, Fan Rong, Peng Fuhua, Jiang Ying

机构信息

Department of Neurology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Department of Neurology, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, China.

出版信息

Front Neurol. 2021 Feb 12;12:601495. doi: 10.3389/fneur.2021.601495. eCollection 2021.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bf7/7907499/c948e1c03ef5/fneur-12-601495-g0001.jpg

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