The Value And Significance Of Netrin-1in Acute Kidney Injury

Objective:To investigate the effects and implication of netrin-1in acute kidney injury (AKI).Methods:A study was conducted in61AKI patients,30ESRD control patients and30control health controls(age,race,and gender-matched). Clinical presentations, urinary and serum samples were collected when the patiens were enrollment into our study. These samples were centrifuged at2000r/min for10minutes, and the supernatant were stored at-8℃until assay.Urinary NAG was analyzed by colorimetry; netrin-1、IL-18and NGAL levels were analyzed by enzyme-linked immunosorbent assay(ELISA) in urinary samples; while serum samples were analyzed by ELISA for caspase-3.Results:1. Campared with normal control group,the urinary netrin-1、IL-18、 NGAL and serum caspase-3values were significantly increased in AKI group (P<0.05), while, there is no significance between normal control group and ESRD control group.2. Multivariable analysis, the urinary netrin-1was positive correlated with the levels of urinary NAG(R=0.259, P<0.05); However,the urinary netrin-1levels was negative associated with the levels of serum creatinine and caspase-3(R=-0.557, P<0.01; R=-0.315, P<0.05), respectively.3. Receiver operator characteristic curve(ROC) analysis showed the area under the curve(AUC) of netrin-1was0.928(95%CI0.875-0.982, P<0.01); IL-18was0.925(95%CI0.869-0.981, P<0.01); NGAL was0.926(95%CI0.872-0.980, P<0.01).Conclusion:1. Urinary NAG, NGAL, IL-18were obviously increased in AKI. showed that these indicators were the classic laboratory marker for the diagnosis of AKI.2. Urinary netrin-1was significantly elevated in patients with AKI and with potentially high sensitivity, suggested that netrin-1may serve as a novel universal biomarker for AKI.3. Urinary netrin-1might be related to the mechanism of apoptosis in patients with AKI.