To Investigate The Changes And Significance Of Urinary ACE2 And L-FABP In Patients With Chronic Kidney Disease

Objective: A number of studies have shown that angiotensin-covertingenzyme 2(angiotensin-covertingenzyme 2,ACE2)in the develop-ment of renal disease in the process of local production increased,which antagonizes the inflammatory effects of the RAS system,slows down renal interstitial fibrosis,delaying renal function progress.It has also been shown that liver-type fatty acid-binding protein(L-FABP,FABP1)is associated with the progression of chronic kidney disease and is a sensitive marker for predicting tubulointerstitial injury.The aim of this study was to investigate the levels of urine in patients with different stages of CKD and to assess whether they were associated.Methods: 83 patients with chronic kidney disease diagnosed for the first time in our hospital were enrolled from May 2000 to December 2016.The eGFR was estimated according to CKD-EPI formula.According to eGFR they were divided into five groups,and the same time selected period of our hospital physical examination center liver and kidney function is normal,no history of hypertension,diabetes history,no cardiovascular disease in 25 cases of healthy subjects as a healthy control group.The following test items were r ecorded in both groups: albumin(ALB),fasting blood glucose(FBG),hemoglobin(HGB),total cholesterol(CHOL),triglyceride(TG),serum creatinine(SCR),uric acid(UA),High sensitivity C-reactive protein(hsCRP)and 24-hour urinary protein quantification(uPro).At the same time,boths groups taken aseptic urine morning urine 5ml,the supernatant was collected after centrifugation at 3000 r / min for 15 min,and the levels of urinary ACE2 and urinary L-FABP were measured by enzyme-linked immunosorbent assay(ELISA)Creatinine correction,the use of SPSS16.0 statistical software for statistical analysis.Results: 1 CKD group compared with the control group,urine ACE2 was signifi cantly increased,as 3793.34±1984.69 ng/mg·Cr vs 905.57±174.40 ng/mg·Cr;CKD group compared with the control group,urine L-FABP was significantly increased,as 56.28±23.67?g/g·Cr vs 9.62±3.49?g/g·Cr(P<0.05).2 Comparison of urine ACE2 and urine L-FABP between CKD groups 2.1 With the decrease of eGFR,urinary ACE2 gradually increased,as C KD1 stage:2255.89±437.92 ng/mg·Cr;CKD2 stage:2323.73±695.52 ng/mg·Cr;CKD3 stage:3063.12±1197.42 ng/mg·Cr;CKD4 stage:4671.68±837.96 ng/mg·Cr;CKD5 stage:6254.38±1987.18 ng/mg·Cr,The difference was statistically significant(P <0.05).2.2 With the decrease of e GFR,urinary L-FABP gradually increased,as CKD1 stage:31.22±11.94?g/gCr;CKD2 stage:44.52±9.10?g/g·Cr;CKD3 stage:51.11±19.90?g/g·Cr;CKD4 stage:61.92±10.77?g/g·Cr;CKD5 stage:87.36±14.02?g/g·Cr,The difference was statistically significant(P <0.05).2.3 CKD1 urine urine ACE2 urine L-FABP and that was significantly higher than the control group,as ACE2:CKD1 stage:2255.89±437.92 ng/mg·Cr vs Control group:905.57±174.40 ng/mg·Cr;L-FABP: CKD1 stage:31.22±11.94?g/g·Cr vs Control group:9.62±3.49?g/g·Cr(P<0.05).3 Single factor correlation analysis showed that urinary ACE2 was posit ively correlated with SCr and negatively correlated with HGB,eGFR and TG.Single factor correlation analysis showed that urinary L-FABP was positively correlated with SCr and negatively correlated with HGB and eGFR.4 Multiple linear regression analysis DBP,ALB,eGFR,urinary L-FABP were determined by using urinary A CE2 as strain,age,SBP,DBP,hs-CRP,ALB,UA,CHOL,FBG,uPro,TG,HGB and e GFR as independent variables Independent factors influencing urinary ACE2 levels.Conclusions:1.Urinary L-FABP,urinary ACE2 levels are associated with increased renal function,both as a marker of renal damage,and predict the progress of renal function.2.Urinary ACE2 can be used as an indicator of the activation of the RAS system in the kidneys.3.Urinary L-FABP is an independent predictor of urinary ACE2 levels.