Diagnostic Role Of Urinary Angiotensinogen In Chronic Kidney Disease And TCM Syndrome Type Correlation Research

Objective: This study examined the expression of urinary angiotensinogen(AGT)in patients with chronic kidney disease(CKD)and explored whether urinary AGT can be a biomarker for early diagnosis of CKD and whether it can become a CKD TCM certificate.Objective indicators of the type.Methods: 1.From January 2018 to December 2018,60 patients with CKD who met the inclusion and exclusion criteria were enrolled in the Department of Nephrology,Guangxi University of Traditional Chinese Medicine,and 30 patients in the hospital were selected as the control group.Then,according to the specific requirements,the following grouping:(1)According to CKD staging: divided into CKD2 phase group,CKD3 phase group,CKD4 phase group,CKD5 phase group;(2)According to the systolic blood pressure group: in the CKD group and the non-CKD group,in the interval of systolic blood pressure of 100-199 mmHg,grouping every 20 mmHg;(3)TCM syndrome type group: spleen and kidney qi deficiency syndrome group,spleen and kidney yang deficiency syndrome group,liver and kidney yin deficiency syndrome group,Qiyin deficiency syndrome group,yin and yang deficiency syndrome group.2.Record the general information of the two groups,including gender,age,height,weight,etc.,collect laboratory clinical indicators: serum creatinine,blood uric acid,serum albumin,hemoglobin,cholesterol,24-hoururine protein.3.Collect 10 ml of urine in the morning clean(except menstrual period,pregnant women),label the name,specimen number,etc.,freeze at-20 °C after centrifugation,using enzyme-linked immunosorbent assay(ELISA))Detection of urinary AGT.Results:1.The observation group and the control group and the observation group compared the gender,body mass index and other general data in each period of CKD 2~5,the difference was not statistically significant(both P>0.05),the average age of the observation group was higher than the control group,the difference Statistically significant(P < 0.05).Compared with clinical data,serum creatinine,uric acid,24-hour urine protein and other indicators were statistically significant(P<0.05).2.By t test,the urinary AGT level(302.03 ± 54.04)ng/L in the CKD group was significantly higher than that in the non-CKD group(179.63 ±34.71)ng/L,and the difference was statistically significant(P<0.01).The urinary AGT level in the CKD group was further analyzed by one-way analysis of variance,CKD stage 2(290.1±22.44)ng/L,CKD stage 3(299.18±51.21)ng/L,CKD stage 4(292.5±7.65)ng/L,CKD5.The period group(315.91±186.60)ng/L,the difference was not statistically significant((both P>0.05).3.Compared with the same blood pressure level,the urinary AGT level in the CKD group was significantly higher than that in the non-CKD group,and the difference was statistically significant(P<0.01).In the CKD group,the urinary AGT level did not change significantly with the increase of systolic blood pressure.There was no significant difference between the blood pressure groups(P>0.05).4.According to Pearson correlation analysis,there was no significantcorrelation between urinary AGT levels and serum creatinine,blood uric acid,24-hour urine protein,and estimated Glomerular Filtration Rate(eGFR)(all P>0.05).5.The ROC curves of urinary AGT,serum creatinine and 24-hour urine protein were obtained.The areas under the curve were: 0.988,1.000,0.971.The area under the curve of urinary AGT was lower than that of serum creatinine,which was higher than that of 24-hour urine protein.The difference was statistically significant(P=0.000),and the cut-off value when the index was the highest.When CKD was evaluated at 231.4 ng/L,it was sensitive.The sex and specificity were 95.0% and 93.3%,respectively,that is,the true positive rate was 95.0%,and the false positive rate was 6.7%.6.CDK 2~5 TCM syndrome type The most common syndrome of spleen and kidney yang deficiency,spleen and kidney qi deficiency,one-way analysis of variance was used to analyze the level of urinary AGT in different TCM syndromes of CKD patients,including spleen and kidney qi deficiency syndrome(308.8±54.48)ng/ L,spleen and kidney yang deficiency syndrome(308.8±61.64)ng/L,Qiyin deficiency syndrome(302.9±31.41)ng/L,liver and kidney yin deficiency syndrome(316.3 ± 45.89)ng/L,yin and yang deficiency syndrome(273.6±46.23)ng/L,the difference was not statistically significant(both P>0.05).Conclusion: 1.Increased urinary AGT levels may be a non-invasive biomarker for CKD sensitivity,but it does not reflect the severity of kidney disease.2.There may be no correlation between urinary AGT levels and blood pressure levels in CKD patients.3.Urinary AGT level may not be an objective indicator to determine the TCM syndrome type of CKD patients.