Medical Department I, University Hospital Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany.
Department of Nephrology, Charité - Campus Benjamin Franklin, Berlin, Germany.
Ren Fail. 2021 Dec;43(1):417-424. doi: 10.1080/0886022X.2021.1885442.
It has been demonstrated that urinary neutrophil gelatinase-associated lipocalin (NGAL) and calprotectin are helpful biomarkers in the differentiation of intrinsic and prerenal acute kidney injury.
The present cross-sectional study investigates, whether urinary biomarkers are able to differentiate primarily inflammatory from non-inflammatory entities in chronic kidney disease (CKD).
Urinary calprotectin, NGAL, and kidney injury molecule-1 (KIM-1) concentrations were assessed in a study population of 143 patients with stable CKD and 29 healthy controls. Stable renal function was defined as an eGFR fluctuation ≤5 ml/min/1.73 m in the past 12 months. Pyuria, metastatic carcinoma, and renal transplantation were regarded as exclusion criteria. Diabetic nephropathy, hypertensive nephropathy, and polycystic kidney disease were categorized as 'primarily non-inflammatory renal diseases' (NIRD), whereas glomerulonephritis and vasculitis were regarded as 'primarily inflammatory renal diseases' (IRD).
Urinary calprotectin and NGAL concentrations significantly differed between CKD and healthy controls ( < 0.05 each), whereas KIM-1 concentrations did not ( = 0.84). The three biomarkers did neither show significant differences in-between the individual entities, nor the two categories of IRD vs. NIRD (calprotectin 155.7 vs. 96.99 ng/ml; NGAL 14 896 vs. 11 977 pg/ml; KIM-1 1388 vs. 1009 pg/ml; > 0.05 each). Albumin exceeds the diagnostic power of the investigated biomarkers by far.
The urinary biomarkers calprotectin, NGAL, and KIM-1 have no diagnostic value in the differentiation of primarily inflammatory vs. non-inflammatory etiologies of CKD.
已有研究表明，尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和钙卫蛋白有助于区分肾前性和肾性急性肾损伤。
本横断面研究旨在探讨尿生物标志物是否能区分慢性肾脏病（CKD）患者的原发性炎症和非炎症实体。
研究人群包括 143 例稳定 CKD 患者和 29 名健康对照者，检测其尿钙卫蛋白、NGAL 和肾损伤分子-1（KIM-1）浓度。稳定的肾功能定义为过去 12 个月内 eGFR 波动≤5ml/min/1.73m。尿脓细胞、转移性癌和肾移植被视为排除标准。糖尿病肾病、高血压肾病和多囊肾病归类为“主要非炎症性肾脏疾病”（NIRD），而肾小球肾炎和血管炎则归类为“主要炎症性肾脏疾病”（IRD）。
CKD 患者和健康对照组的尿钙卫蛋白和 NGAL 浓度差异有统计学意义（均<0.05），而 KIM-1 浓度差异无统计学意义（=0.84）。这三种生物标志物在个体实体之间或 IRD 与 NIRD 两组之间均无显著差异（钙卫蛋白 155.7 与 96.99ng/ml；NGAL 14896 与 11977pg/ml；KIM-1 1388 与 1009pg/ml；均>0.05）。白蛋白远远超过了所研究生物标志物的诊断能力。
尿生物标志物钙卫蛋白、NGAL 和 KIM-1 对区分 CKD 的主要炎症和非炎症病因无诊断价值。
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