Study On Kidney Damage And Related Predictors In Patients With Acute Exacerbations Of Bronchial Asthma

Objective:Bronchial asthma is a chronic inflammatory disease of the respiratory system.Studies have shown that bronchial asthma is an independent risk factor for kidney disease.The objective of this study was to explore whether there is renal impairment in patients with acute exacerbations of bronchial asthma and to seek relevant predictors in order to identify and treat the associated renal impairment in patients with bronchial asthma in the clinic.Methods:Retrospective studies.From January 2017 to December 2019,121 patients with acute exacerbations of bronchial asthma who were hospitalized in the Department of Respiratory and Critical Care Medicine of the First Hospital of Shanxi Medical University were collected as observation groups,and 182 healthy people from the Health Examination Center of the First Hospital Shanxi Medical University were collected as the control group.Clinical data from patients in the observation group were collected,including age,sex,height,weight,associated symptoms,signs,and arterial blood p H in blood gas analysis,arterial partial pressure of oxygen(Pa O2),partial pressure of arterial blood carbon dioxide(Pa CO2),arterial oxygen saturation(Sa O2),and peak expiratory flow(PEF)on pulmonary function tests.According to the above indicators,patients are divided into mild group and moderate to severe group according to the severity of the disease.The renal function indicators of the observation group and the control group,including urine protein,urine occult blood,blood creatinine(Scr),urea nitrogen(BUN),cystatin C(Cys-C),and β2-microglobulin(β2-MG),were collected,and the differences in the renal function indicators associated with the observation group and the control group,mild group and moderate to severe group were compared.ROC curves were plotted to assess the early predictive value of Cys-C and β 2-MG in predicting renal damage in patients with acute exacerbations of bronchial asthma.Results:1.There was no significant difference between baseline data in the observation group and the control group(P>0.05).2.The differences in urine protein,urine occult blood,Cys-C and β2-MG in the observation group were statistically significant compared with the control group(P<0.05),and Scr and BUN were not significant between the two groups(P>0.05).3.Compared with the moderate to severe group,the differences in urine protein,urine occult blood,Scr,BUN,Cys-C and β2-MG were statistically significant(P<0.05).4.The under-curve area of Cys-C(AUC-ROC value)is 0.909,with high specificity(98.7%)and high sensitivity(79.5%).(AUC-ROC value)The under-curve area of β2-MG(AUC-ROC value)is 0.675,the sensitivity and specificity are(58.1%,79.5%)respectively,and the AUC-ROC value of Cys-C is significantly higher than that of β2-MG(P<0.05).Conclusion:1.Patients with acute exacerbations of bronchial asthma have potential renal damage,and the degree of damage increases with the severity of the disease,suggesting that patients with bronchial asthma should pay attention to the changes in their renal function indicators during the acute attack.2.Cys-C and β2-MG have some early predictive value for potential renal damage during acute exacerbations in patients with bronchial asthma.