Abstract:
Objective To evaluate the predictive value of combined detection of urine KIM-1, NGAL, and RBP for early renal injury in patients with chronic hepatitis B.
Methods One hundred and thirty-three chronic hepatitis B patients admitted to Peking University People's Hospitalfrom January 2021 to July 2022 were included, and based on the urinary albumin/creatinin ratio (UACR), they were divided into either a non-injury group (UACR<30 mg/g, 73 cases) or an injury group (UACR≥30 mg/g, 60 cases). Sixty healthy volunteers who underwent physical examination during the same period were selected as a control group. The urine levels of kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and retinol binding protein (RBP) were detected in the three groups. Clinical data were collected. The correlation of urine KIM-1, NGAL, and RBP with UACR was analyzed. The predictive value of urine KIM-1, NGAL, and RBP, either alone or in combination, for early renal injury in patients with chronic hepatitis B was assessed by ROC curve analysis.
Results The urine levels of KIM-1, NGAL, and RBP in the injury group were significantly higher than those of the non-injury group and control group (P<0.05). There were no significant differences in urine KIM-1, NGAL, and RBP between the non-injury group and control group (P>0.05). Urine KIM-1, NGAL, and RBP were positively correlated with UACR in chronic hepatitis B patients (r=0.589, 0.359, and 0.519, respectively, P<0.05). ROC curve analysis showed that KIM-1, NGAL, and RBP had appreciated predictive value for early kidney injury in chronic hepatitis B patients; the area under the curve was 0.878, 0.761, and 0.870, the sensitivity was 73.33%, 48.33%, and 78.33%, and the specificity was 89.04%, 94.52%, and 84.93, respectively. The area under the curve, sensitivity (91.70%), and specificity (97.30%) of the three indexes combined were all significantly higher than those of any one of them alone (P<0.05).
Conclusion Urinary KIM-1, NGAL, and RBP levels are significantly increased in patients with chronic hepatitis B during early renal injury, and combined detection of them has higher predictive value for early renal injury in such patients.
Key words:
Urinary kidney injury molecule 1,
Neutrophil gelatinase-associated lipid,
Retinol binding protein,
Chronic hepatitis B,
Early renal injury,
Predictive value
Lichao Lian, Ziyue Fan, Xin Zhang, Li. Bai. Predictive value of combined detection of urine KIM-1, NGAL, and RBP for early renal injury in patients with chronic hepatitis B[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(04): 414-418.