Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan.
Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Clin Exp Nephrol. 2021 Oct;25(10):1151-1157. doi: 10.1007/s10157-021-02088-7. Epub 2021 Jun 7.
Liver-type fatty acid-binding protein (L-FABP) in urine is one of the early diagnostic biomarkers for acute and chronic kidney injuries. Although this protein is also identified in the intestine, there is no verified reference value for patients with intestinal urinary diversion (UD). The aim of the present study was to measure L-FABP values in such patients and compare them with the results for patients without UD.
Spot urine specimens were collected from 41 patients with UD and 50 subjects without UD with estimated glomerular filtration rates of over 60 ml/min/1.73 m, and the L-FABP values were measured. The normal upper cutoff value in healthy subjects without UD is considered to be 7.24 μg/g Cr. First, the median values of the two groups were compared. Next, the subjects with negative proteinuria and without comorbidities associated with renal function were further selected and the median values of the groups were compared.
The mean age was significantly higher in the UD group. The types of UD were ileal conduit (38 patients) and ileal neobladder (three patients). The median L-FABP value in the UD group was significantly higher than that in the non-diversion group (89.1 μg/g Cr vs. 2.0 μg/g Cr, p < 0.0001). After adjustment for their backgrounds, the median value remained higher in the UD group.
L-FABP values in subjects with UD are higher than in those without UD. By this result, to develop a reference value in patients with intestinal UD population, further studies are required.
尿中肝型脂肪酸结合蛋白(L-FABP)是急性和慢性肾损伤的早期诊断生物标志物之一。虽然这种蛋白质也在肠道中被识别,但对于肠尿路分流(UD)的患者,没有经过验证的参考值。本研究的目的是测量这些患者的 L-FABP 值,并将其与无 UD 患者的结果进行比较。
收集 41 例 UD 患者和 50 例无 UD 且估计肾小球滤过率(eGFR)大于 60 ml/min/1.73 m2 的患者的随机尿标本,并测量 L-FABP 值。无 UD 的健康受试者的正常上限值被认为是 7.24 μg/g Cr。首先比较两组的中位数。接下来,进一步选择无蛋白尿且无肾功能相关合并症的患者,并比较两组的中位数。
UD 组的平均年龄明显较高。UD 的类型为回肠造口术(38 例)和回肠新膀胱术(3 例)。UD 组的 L-FABP 中位数明显高于非分流组(89.1 μg/g Cr 比 2.0 μg/g Cr,p<0.0001)。调整背景因素后,UD 组的中位数仍然较高。
UD 患者的 L-FABP 值高于无 UD 患者。根据这一结果,需要进一步研究以确定肠 UD 患者人群的参考值。