Clinical Significance Of Urinary Kidney Injury Molecule-1 In IgA Nephropathy

Objective:To demonstrate the correlation between urinary kidney injury molecule-1(KIM-1)and clinical indicators and pathological grades in Ig A nephropathy patients,in order to evaluate the clinical value urinary KIM-1.Methods:75 Ig A nephropathy patients diagnosed at our hospital during the period of December 2017 to May 2019 were selected as the Ig AN group.Meanwhile 55 healthy volunteers were selected as the control group.According to Lee's classification standard,75 Ig A nephropathy patients were divided into five grades as followed: the mild injury group include grade I-II,the moderate injury groupinclude grade III,the severe injury group include grade IV-V.Urinary KIM-1 were detected with enzyme-linked immuno sorbent assay(ELISA).The correlations among urinary KIM-1 and clinical indicators(Cys C,TRF,FDP,24 h urinary protein excretion,urinary microalbumin,Scr,e GFR)and pathological grades in Ig A nephropathy were investigated.Spss23.0 statistical software was used for statistical processing.T-test is used for two groups of measurement data of normal distribution,and nonparametric test is used for comparison between groups of measurement data of non normal distribution,and the Spearman test was used for the correlation analysis.Results:1.The level of urinary KIM-1 in Ig A nephropathy patients was significantly higher compared with control group(2.73(5.13)ng/m vs.0.59(1.24)ng/ml)(Z=-5.73,P<0.05).2.The differences in urinary KIM-1(1.07(1.03)ng/ml vs.1.99(3.18)ng/ml vs.8.43(8.78)ng/ml)among group of mild,moderate,and severe were statistically significant(H=34.831,P<0.05).3.The urinary KIM-1 level was positively correlated with Cys C,TRF,FDP,24 h urinary protein excretion,urinary microalbumin(r values were 0.466,0.498,0.397,0.487,0.250 respectively,P<0.05),and was negatively correlated with e GFR(r values was-0.243,P=0.036),no significant correlation with Scr(r=0.176,P=0.131).4.The area under the ROC curve of urinary KIM-1 was 0.800 for the evaluation of Glomerular function in patients with Ig AN which was higher compared with Scr,Cys C,TRF and FDP(AUC=0.708,0.784,0.762,0.754).Conclusion:Urinary KIM-1 has clinically practical value in early predicting the severity of Ig A nephropathy.