血清尿调蛋白在慢性肾病犬中的作用。
Serum uromodulin in dogs with chronic kidney disease.
机构信息
Laboratory of Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea.
Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
出版信息
J Vet Intern Med. 2022 Nov;36(6):2071-2078. doi: 10.1111/jvim.16579. Epub 2022 Nov 4.
BACKGROUND
Serum uromodulin concentration has been described as a novel biomarker of chronic kidney disease (CKD) in humans but not dogs.
OBJECTIVE
To evaluate the serum uromodulin concentration in dogs with CKD and assess its diagnostic performance in distinguishing dogs with CKD from healthy dogs.
ANIMALS
Forty-nine dogs with CKD (International Renal Interest Society [IRIS] Stage 1, n = 23; Stage 2, n = 20; Stage 3-4, n = 6) and 25 healthy controls.
METHODS
Prospective, observational study. Serum uromodulin concentration was measured using a canine-specific enzyme-linked immunosorbent assay (ELISA), and its correlation with conventional renal markers was analyzed.
RESULTS
Serum uromodulin concentrations were significantly lower in the CKD group than in the control group (P < .001), but no significant difference was observed among stages of CKD. A negative correlation was observed between serum uromodulin concentration and conventional renal markers (blood urea nitrogen concentration, r = -.60, P < .0001; serum creatinine concentration, r = -.46, P < .0001; serum symmetric dimethylarginine concentration [SDMA], r = -.65, P < .0001). In receiver operating characteristic analysis, the area under the curve (AUC) of uromodulin (AUC, 0.97; 95% confidence interval [CI], 0.94-1.00) was higher than that of SDMA (AUC, 0.87; 95% CI, 0.79-0.95) for CKD diagnosis (P = .01). The AUC of uromodulin (AUC, 0.95; 95% CI, 0.89-1.00) also was higher than that of SDMA (AUC, 0.72; 95% CI, 0.58-0.87) in distinguishing dogs with Stage 1 CKD from controls (P = .001).
CONCLUSIONS AND CLINICAL IMPORTANCE
Serum uromodulin concentration is decreased in dogs with CKD. Thus, serum uromodulin may be a valuable diagnostic marker for CKD in dogs, particularly in identifying early-stage CKD.
背景
血清尿调蛋白浓度已被描述为人类慢性肾脏病（CKD）的一种新型生物标志物，但尚未在犬中进行描述。
目的
评估 CKD 犬的血清尿调蛋白浓度，并评估其在区分 CKD 犬与健康犬方面的诊断性能。
动物
49 只 CKD 犬（国际肾脏协会[IRIS]分期 1 期，n=23；分期 2 期，n=20；分期 3-4 期，n=6）和 25 只健康对照。
方法
前瞻性观察性研究。使用犬特异性酶联免疫吸附测定（ELISA）测量血清尿调蛋白浓度，并分析其与常规肾脏标志物的相关性。
结果
CKD 组的血清尿调蛋白浓度明显低于对照组（P < .001），但 CKD 各阶段之间无显著差异。血清尿调蛋白浓度与常规肾脏标志物呈负相关（血尿素氮浓度，r = -.60，P < .0001；血清肌酐浓度，r = -.46，P < .0001；血清对称二甲基精氨酸浓度[SDMA]，r = -.65，P < .0001）。在受试者工作特征分析中，尿调蛋白的曲线下面积（AUC）（AUC，0.97；95%置信区间[CI]，0.94-1.00）高于 SDMA（AUC，0.87；95% CI，0.79-0.95）用于 CKD 诊断（P = .01）。尿调蛋白（AUC，0.95；95% CI，0.89-1.00）的 AUC 也高于 SDMA（AUC，0.72；95% CI，0.58-0.87）用于区分 1 期 CKD 犬与对照组（P = .001）。
结论和临床意义
CKD 犬的血清尿调蛋白浓度降低。因此，血清尿调蛋白可能是犬 CKD 的一种有价值的诊断标志物，特别是在识别早期 CKD 方面。
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