Diagnostic value of combined detection of four-item urinary protein for early hypertensive kidney injury

Abstract

Objective To investigate the diagnostic value of combined detection of urine α1-microglobulin(α1-mG), N-acetyl-β-D-glucosaminidase (NAG), retinol binding protein (RBP) and β2-microglobulin (β2-mG) for early hypertensive kidney injury. Methods From June 2016 to December 2018, 116 hypertension patients with renal damage (HRD group) and 44 cases with simple hypertension(HBP group) were selected in the Central People′s Hospital of Tengzhou in this study.And 36 cases of healthy people during the same period were selected as the control group.One hundred and sixteen cases of the HRD group were divided into Ⅰ-Ⅱ group (61 cases) and Ⅲ-Ⅴ group (55 cases) according to the classification of chronic kidney disease(CKD). The concentrations of α1-mG, NAG, RBP and β2-mG in urine were detected in patients and healthy people respectively.SPSS 19.0 software was used to perform statistical analysis. Results The concentrations of urine α1-mG, NAG, RBP, β2-mG in the HRD group were (41.77±24.21)mg/L, (22.60±13.24)U/L, (2.86±1.73)mg/L, (1.76±0.95)mg/L, respectively, which in the HBP group were (12.49±8.10)mg/L, (13.45±8.61)U/L, (0.31±0.16)mg/L, (0.38±0.38)mg/L, respectively, which in the control group were (4.37±2.52)mg/L, (6.12±3.57)U/L, (0.29±0.17)mg/L, (0.28±0.15)mg/L, respectively.The concentrations of urine α1-mG, NAG, RBP, β2-mG in the HRD group were significantly higher than those in the HBP group(t=4.07, 4.25, 4.09, 4.03, all P<0.05) and the control group(t=3.15, 4.94, 2.49, 2.61, all P<0.05). The urine levels of α1-mG, NAG, RBP, β2-mG in phase Ⅰ-Ⅱ group were (21.62±13.45)mg/L, (21.96±12.49)U/L, (0.5±0.47)mg/L, (0.93±0.62)mg/L, respectively, which in the phase Ⅲ-Ⅴ group were (64.11±60.12)mg/L, (23.32±14.11)U/L, (5.48±4.77)mg/L, (2.68±2.55)mg/L, respectively.The concentrations of urine α1-mG, NAG, RBP and β2-mG in Ⅰ-Ⅱ group (t=5.08, 4.99, 2.96, 1.66, all P<0.05) and Ⅲ-Ⅴ group (t=3.95, 4.81, 4.33, 3.74, all P<0.05) were significantly higher than those in the control group.The levels of α1-mG, RBP and β2-mG in group Ⅲ-Ⅴ were higher than those in group Ⅰ-Ⅱ(t=5.37, 8.11, 4.52, all P<0.05). The positive detection rates of α1-mG, NAG, RBP, β2-mG and combination test in phase Ⅰ-Ⅱ group were 70.5%, 77.0%, 19.7%, 60.7%, 91.8%, respectively, which in the phase Ⅲ-Ⅴ group were 81.8%, 81.8%, 69.1%, 69.1% and 96.4%, respectively.The positive rate of urine α1-mG, NAG, RBP and β2-mG combination test was significantly higher than that of the single detection (phase Ⅰ-Ⅱ group: χ2=7.71, 3.99, 61.4, 14.65; phase Ⅲ-Ⅴ group: χ2=4.58, 4.58, 12.47, 12.47; all P<0.05). Conclusion Urine α1-mG, NAG, RBP and β2-mG are important biochemical indicators in patients with early hypertensive kidney injury.The combined detection of the four tests has high diagnostic value in the diagnosis of early hypertensive nephropathy. Key words: Hypertension; Urine protein; Early hypertensive kidney injury; α1-microglobulin; N-acetyl-β-D-glucosaminidase; Retinol binding protein; β2-microglobulin; Combined detection