Relationship Between Aging Kindey And Antinuclear Antibody And Its Influencing Factors

Objective: Here we evaluated the antinuclear antibody(ANA),serum creatinine,cystatin C(Cys C),and estimated glomerular filtration rate(e GFR)in elderly paitent.e GFR is used as an index to evaluate renal function.To study the relationship between aging ANA and aging renal function in elderly patients and its influencing factors,and to explore whether aging kidney in elderly patients is related to a series of reactions caused by DNA damage,Which will provide a theoretical basis for further study on the role of DNA damage repair in kidney and whether DNA damage repair can delay renal aging.To see if it may benefit in early prevention,early detection and early treatment of the aging kidney,thus slowing down the aging process of the kidney.Methods: Our samples were the hospitalized patients who were aged 60 or older in our hospital from June 2015 to December 2017.Exclusion criteria:(1)clinically suspected or confirmed connective tissue diseases,such as systemic lupus erythematosus,rheumatoid arthritis,Sjogren's syndrome,primary vasculitis,systemic sclerosis;(2)acute renal failure;(3)Clear diagnosis of kidney disease,such as nephrotic syndrome,glomerular disease,Ig A nephropathy,secondary nephropathy;(4)isolated kidney,unilateral renal atrophy and renal artery stenosis;(5)chronic kidney disease were caused by some clear reasons,such as drugs,Hepatitis B,syphilis,tubulointerstitial disease,hereditary nephropathy,renal vascular disease;(6)Hypertension,diabetes mellitus,hepatitis B patients have been diagnosed;(7)A serious infection;malignant tumor,tuberculosis patients;(8)C hepatitis,primary biliary Cirrhosis,autoimmune liver disease,hematopoietic system diseases,psoriasis and other diseases that may cause a rise in the positive rate of ANA.Basic clinical information of all research subjects includinggender,age,medical history and so on were collected.admission fasting blood collection serum creatinine,blood urea nitrogen,blood lipids,ANA,urine routine,liver biochemistry and other laboratory data.According to the results of ANA test,the titer?1: 100 was positive,and the distribution trend of ANA in elderly patients was explored according to the titer level.e GFR levels were estimated in the data according to modified MDRD formula,CKD-EPI-Scr 2009 version and CKD-EPI-Scr-Cys C 2012 version.Based on the e GFR values calculated based on the formula of creatinine and cystatin C in 2012,the relationship between e GFR values with ANA were discussed in differrent e GFR level groups.Results: 1.387 patients were enrolled in this study,including 149 males(38.5%)and 238 females(61.5%).Aged 60 to 96 years old,the average age was 69.01 ± 8.23 years.2.There were 173 positive cases of ANA in the e GFR decline group,accounting for 66.0% of the e GFR decreased group,which was significantly higher than 55.2% of the ANA positive rate in the e GFR normal group(P <0.05).Compared with the normal e GFR group,the age,leukocyte,neutrophil,blood urea nitrogen,serum creatinine,serum uric acid,cystatin C,total cholesterol and Ig E were higher in patients with e GFR decline,while lymphocytes,hemoglobin,blood Albumin,HDL-L and Ig M were lower(P <0.05).3.ANA positive patients included a total of 242 cases,accounting for 62.5% of the total specimens.Compared with patients with anti-nuclear antibody negative,the mean age and Ig G were higher in anti-nuclear antibody-positive patients(P <0.05).e GFR was lower based on the three e GFR formulas(P <0.05).4.The positive rate of ANA increased with the decrease of e GFR.The positive rate of ANA in e GFR decreased significantly(79.6%)than that in the other two groups(P <0.05).However,there was no significant difference in the positive rate of ANA between mild e GFR group and e GFR normal group(P> 0.05).5.The positive titer of ANA between different e GFR level groups was low titer(1: 100).Among the e GFR significantly decreased group,16 cases(accounting for 32.7% of the total)had positive titer of 1: 320 were higher than the other two groups with the same titer positive rate(P <0.05).6.The most common karyotypes of 242 ANA positive patients were speckled+ cytoplasmic speckled(83 cases,34.3%),followed by cytoplasmic speckled(72 cases,29.8%),speckled+ homogeneous(13 cases,5.4%),homogeneous(12 cases,5.0%),homogeneous + cytoplasmic speckled(8 cases,3.3%),nucleolar(5 cases,2.1%),nucleolar + cytoplasmic speckled(4,1.7%)and nucleolar + speckled(1,0.4%).A total of 133 samples(55%)of the total sample in a single model,a total of 109 cases(42%)mixed the two models.There was no significant difference in the distribution of ANA karyotypes between different e GFR groups.7.The positive rate of ANA in female patients(66.4%)was higher than that in male patients(56.4%)(P <0.05).8.After adjusting for gender,the positive rate of ANA in all age groups gradually increased with the increase of age in the total sample size.9.GFR levels decreased with age physiological decline(P <0.05).Logistic regression analysis showed that age and hyperuricemia were independent risk factors for the decline of renal function.10.Spearman analysis showed that the level of ANA in the elderly was negatively correlated with the e GFR level calculated by the CKD-EPI-Scr-Cys C 2012 formula(rs =-0.163,P = 0.001 <0.05).Conclusions: The positive rate of antinuclear antibody in elderly patients increased with age,and the positive rate of ANA in patients with decreased e GFR was significantly higher than that in normal e GFR patients.The study found the relationship between with aging kidney and DNA damage,suggesting that DNA damage repair is playing a role in in aging kidney.