Study On The Relationship Between NGAL?klotho Gene And Hypertensive Disorders In Pregnancy?acute Kidney Injury

Objective (s): To study the relationship between NGAL?Klotho and hypertensive disorder in pregnancy with Acute Kidney Injury ( AKI),and the effect of Klotho in the pathogenesis of AKI.Methods: Collect the the clinical data of 79 pregnant women hospitaled in obstetrics of the First Affiliated Hospital of Kunming Medical University from April 2016 to July 2016, the pregnant women were divided into 3 groups: normal pregnancy group(30 cases)?hypertensive disorders group(40 cases)?hypertensive disorders and AKI group (9 cases) according to whether pregnant women with hypertensive disorders and AKI. The expression of Klotho gene in the blood of the above three groups was detected by PCR, and the Klotho?NGAL in the serum of the above three groups were detected by Elisa, MDA and SOD were detected by enzymic method , and the differences among the three groups were compared.Results: 1.The serum NGAL concentrations of group with AKI and hypertensive disorders in pregnancy?group with hypertensive disorders in pregnancy and normal group were (234.50 + 90.85) ng/ml?(181.25 + 65.86) ng/ml and (113.23 + 40.87)ng/ml, the difference was statistically significant (P <0.001), further comparison showed difference among three groups was statistically significant.the serum NGAL and serum creatinine (r=0.526, P <0.001)?urea nitrogen (r=0.324, P =0.004)? uric acid (r=0.429,P <0.001).systolic blood pressure (r=0.465, P <0.001)?diastolic blood pressure (r=0.47, P <0.001)?24h urinary protein (r=0.253, P =0.024) were positively related.2.The Klotho/?-actin of group with AKI and hypertensive disorders in pregnancy?group with hypertensive disorders in pregnancy and normal group were (0.34±0.02 ) ?(0.46±0.02)? (0.64±0.04), The serum Klotho concentrations of group with AKI and hypertensive disorders in pregnancy ?group with hypertensive disorders in pregnancy and normal group were (5.73±0.90) pg/ml?8.44±1.05) pg/ml?(12.14±1.47)pg/ml, the difference was statistically significant (P <0.001), further comparison showed difference among three groups was statistically significant.the serum Klotho and serum creatinine (r=-0.7, P <0.001) was negatively related.3.The serum SOD concentrations of group with AKI and hypertensive disorders in pregnancy?group with hypertensive disorders in pregnancy and normal group were(74.8013.28) U/ml?(80.32±9.88) U/ml?(85.83±5.89) U/ml, the difference was statistically significant (P =0.001), The serum MDA concentrations of group with AKI and hypertensive disorders in pregnancy?group with hypertensive disorders in pregnancy and normal group were (6.80±0.59) nmol/ml?(5.42±1.14) nmol/ml?(4.62±0.67) nmol/ml, the difference was statistically significant (P <0.001),further comparison showed difference among three groups was statistically significant.the serum MDA and serum Klotho (r=-0.455, P <0.001) was negatively related.4. Mediator effect analysis showed that the effect of Klotho protein to creatinine had part of the direct effect, part effect of Klotho protein to creatinine was produced by MDA which was a intermediate variable,the contribution rate of MDA to the total effect was 17.54%.Conclusion(s): 1. The serum NGAL concentrations of group with AKI and hypertensive disorders in pregnancy?group with hypertensive disorders were higher than normal group,further comparison showed difference among three groups was statistically significant.the serum NGAL and serum creatinine?urea nitrogen?uric acid?systolic blood pressure?diastolic blood pressure?24h urinary protein were positively related. It indicates that NGAL may be involved in the pathogenesis of hypertensive disorders in pregnancy, and NGAL may be used for early diagnosis of hypertensive disorder in pregnancy with AKI.2.Klotho protein was negatively related to serum creatinine, and the expression of Klotho gene and protein in the blood of pregnant women with hypertensive and AKI was decreased, it indicats that Klotho plays an important role in the pathogenesis of AKI.3. The decreased expression of Klotho and increased oxidative stress may be the cause of AKI.