Correlation Between Klotho Protein Concentration In Serum And Urine And Severity And Prognosis Of Primary IgA Nephropathy

IgA nephropathy(IgAN)is the most common primary glomerular disease in the world at present.In recent years,researches on serum and urine biomarkers related to IgAN are increasing day by day.Klotho protein is mainly expressed in renal tubular epithelial cells,of which secretory Klotho protein has a variety of biological functions and often functions as an endocrine hormone in vivo.Previous studies have shown that Klotho protein concentration is correlated with the occurrence and development of primary IgAN.Objective:Determine the correlation of serum and urine Klotho protein concentration with the severity,pathological changes and prognosis of primary IgAN.Methods: Patients with primary IgAN who were first diagnosed by kidney biopsy from April 2017 to January 2019 without immunosuppressive therapy were selected as the experimental group.Patients with primary glomerulonephritis were selected as the experimental control group.In addition,healthy volunteers were selected as the normal control group.Fasting serum and morning urine of the above three groups were collected respectively,and the concentration of Klotho protein was detected by enzyme-linked immunosorbent assay(ELISA).At the same time,the general conditions of the experimental group and the experimental control group were collected,including age,gender and relevant laboratory examination results including indexes such as blood creatinine,urea nitrogen,liver function,blood lipid,blood routine,urine routine,etc.Analyze the relationship between serum and urine Klotho protein concentration and related indexes.The data were analyzed with SPSS23.0 statistical software.Results:1Correlation of serum Klotho protein concentration with severity and prognosis of primary IgAN 1.1 Compared with non-IgAN patients with primary glomerulonephritis,there were statistical differences in e GFR and CKD staging between groups(P<0.05),and CKD stage also indicated that the condition of primary IgAN patients was more severe.In terms of nutritional status and lipid metabolism,patients with primary IgAN have a relatively mild illness(P<0.05).1.2 The concentration of serum Klotho protein in patients with primary glomerulonephritis was significantly lower than that in normal control group(P<0.05).There was no significant difference in serum Klotho protein concentration between primary IgAN and non-IgAN patients with primary glomerulonephritis(P>0.05).1.3 The serum Klotho protein concentration in patients with primary IgAN is inversely proportional to CREA(P<0.05,r=-0.630)and BUN(P<0.05,r=-0.669),and directly proportional to CO2 combining power(P<0.05,r=0.440),TBi L(P<0.05,r=0.460),Hb(P<0.05,r=0.580),RBC(P<0.05,r=0.490)and e GFR(P<0.05,r=0.783).1.4.The serum Klotho protein concentration in patients with primary IgAN is related to WHO classification of kidney diseases and CKD stage,which is decreases with the deterioration of renal pathological conditions(P<0.05).2Correlation between urinary Klotho protein concentration with severity and prognosis of primary IgAN2.1 The onset age of primary IgAN patients is younger than that of non-IgAN patients with primary glomerulonephritis(P<0.05).2.2 Compared with non-IgAN patients with primary glomerulonephritis,e GFR of primary IgAN patients decreased significantly(P<0.05),and there were statistical differences in CKD staging between groups(P<0.05).In terms of nutritional status and lipid metabolism,the condition of primary IgAN is relatively mild(P<0.05).2.3 The urinary Klotho protein concentration in patients with primary glomerulonephritis is significantly lower than that in normal control group(P<0.05).The urinary Klotho protein concentration in patients with primary IgAN is lower than that in patients with non-IgAN primary glomerulonephritis,MN group and mild Ms PGN group(P<0.05).2.4 Urinary Klotho protein concentration in patients with primary IgAN is inversely proportional to CREA(P<0.05,r=-0.292)and UA(P<0.05,r=-0.334),and is directly proportional to blood calcium(P<0.05,r=0.381)and e GFR(P<0.05,r=0.376).2.5 Urinary Klotho protein concentration in patients with primary IgAN is correlated with Oxford-typed tubule atrophy/interstitial fibrosis index,and decreases with the aggravation of tubule atrophy/interstitial fibrosis(P<0.05).Conclusion:1 The concentration of Klotho protein in serum and urine is correlated with the development of primary IgAN,and the concentration of Klotho protein decreases with the aggravation of the disease.2 Serum Klotho protein concentration can guide the evaluate the severity,pathological changes and prognosis of primary IgAN.3 Urinary Klotho protein concentration can help the diagnosis,evaluation of severity and pathological changes of primary IgAN.4 Serum and urine Klotho protein concentrations can be used to assist in diagnosis,assessment of disease condition and prognosis of primary IgAN.