Urinary actin, interleukin-6, and interleukin-8 may predict sustained ARF after ischemic injury in renal allografts
Urinary actin, interleukin-6, and interleukin-8 may predict sustained ARF after ischemic injury in renal allografts
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DOI：
10.1016/s0272-6386(03)00206-3
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发表时间：
2003-05-01
影响因子：
13.2
通讯作者：
Kelly, KJ
中科院分区：
文献类型：
--
作者：
Kwon, O;Molitoris, BA;Kelly, KJ
背景。缺血后的细胞损伤和炎症会导致持续性急性肾衰竭（ARF）。方法：为了量化缺血后 ARF 中的细胞损伤和炎症以及肾功能结果的识别标志物，对来自 40 名同种异体肾移植受者（包括 30 名尸体（9 名“持续 ARP”和 21 名“恢复”受试者）和 10 名活体供体同种异体移植物（“LD”））的尿液样本进行了肌动蛋白、γ-谷氨酰转胃酶（GGTP）、乳酸脱氢酶（LDH）、移植后第一周的白细胞介素 6 (IL-6)、肿瘤坏死因子 α (TNF-α) 和白细胞介素 8 (IL-8)。结果：第 0 天，与注定要恢复的受者相比，注定要持续 ARF 的受者中尿肌动蛋白、GGTP、IL-6 和 IL-8 升高。对于肌动蛋白，持续 ARF、恢复和 LD 组中每克尿肌酐的中值分别为 263.9、0.0 和 0.0 微克； 5000.0、892.9 和 5555.6 U（GGTP）； IL-6 为 193.1、27.2 和 10.5 ng； IL-8 分别为 382.0、17.8 和 18.5 ng。相反，与持续 ARF 的受者相比，功能恢复的受者的尿 LDH 和 TNF-α 有所增加。 LDH 的相应中值为 36.7 和 16.3 U（恢复与持续 ARF），TNF-α 的相应中值为 18.4 和 7.6 ng（LD 与持续 ARF）。使用受试者操作特征曲线进行计算分析发现，第 0 天尿肌动蛋白、IL-6 和 IL-8 升高是持续 ARF 的强预测因素，计算得出的曲线下面积分别为 0.75、0.91 和 0.82。结论：尿肌动蛋白、IL-6 和 IL-8 增加可能是预测缺血后持续 ARF 的有用标志物。
Background. Cellular damage and Inflammation after ischemia contribute to sustained acute renal failure (ARF). Methods: To quantify cellular damage and inflammation In postischemic ARF and Identity markers of renal functional outcome, urine specimens from 40 renal allograft recipients, Including 30 cadaveric (9 "sustained ARP" and 21 "recovery" subjects) and 10 living donor allografts ("LD"), were analyzed for actin, gamma-glutamyl transpepticlass (GGTP), lactate dehydrogenase (LDH), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) during the first posttransplant week. Results: On day 0, urinary actin, GGTP, IL-6, and IL-8 were elevated in recipients destined to have sustained ARF compared with those destined to recover. Median values per gram of urine creatinine in the sustained ARF, recovery, and LD groups were 263.9, 0.0, and 0.0 mug, for actin; 5000.0, 892.9, and 5555.6 U for GGTP; 193.1, 27.2, and 10.5 ng for IL-6; and 382.0, 17.8, and 18.5 ng for IL-8, respectively. In contrast, urinary LDH and TNF-alpha increased In recipients with recovering function compared with those who had sustained ARF. The corresponding median values were 36.7 and 16.3 U (recovery versus sustained ARF) for LDH, and 18.4 and 7.6 ng (LD versus sustained ARF) for TNF-alpha. Computational analyses using the Receiver Operating Characteristic Curve found that elevated urinary actin, IL-6, and IL-8 on day 0 were strong predictors of sustained ARF, where the calculated areas under the curve were 0.75, 0.91, and 0.82, respectively. Conclusion: Increased urinary actin, IL-6, and IL-8 may be useful markers for the prediction of sustained ARF after ischemia.