Clinical evaluation of urinary excretion of liver-type fatty acid-binding protein as a marker for the monitoring of chronic kidney disease: A multicenter trial
Clinical evaluation of urinary excretion of liver-type fatty acid-binding protein as a marker for the monitoring of chronic kidney disease: A multicenter trial
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DOI：
10.1016/j.lab.2004.12.003
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发表时间：
2005-03-01
期刊：
影响因子：
--
通讯作者：
Kimura, K
中科院分区：
文献类型：
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作者：
Kamijo, A;Sugaya, T;Kimura, K
为了证实尿肝型脂肪酸结合蛋白（L-FABP）测定在慢性肾脏病（CKD）中的临床应用价值，我们进行了一项多中心试验。在非糖尿病CKD患者（n = 48）中，每1至2个月测量一次临床标志物，持续一年。我们根据疾病进展率将患者回顾性分为进展组（n = 32）和非进展组（n = 16），然后评估几种临床标志物。两组的肌酐清除率（Ccr）相似，但前者的尿L-FABP水平明显高于后者（111.5 μ g/g肌酐vs 53 μ g/g肌酐，P <0.001）。对于监测CKD，我们将尿L-FABP和尿蛋白的截止值分别设定为17.4 μ g/g肌酐和1.0 g/g肌酐。尿L-FABP比尿蛋白对CKD进展的预测更敏感（分别为93.8%和68.8%）。然而，尿蛋白比尿L-FABP表现出更高的特异性（分别为93.8%和62.5%）。随着时间的推移，CKD的进展往往与尿L-FABP的变化相关（r =-0.32，P <0.05），但与尿蛋白的变化无关（r = 0.18，不显著）。尿蛋白的动态变化与尿L-FABP不同，后者随Ccr下降而增加。尿L-FABP比尿蛋白更能预测CKD的进展。随着肾功能的恶化，尿中L-FABP的排泄量增加。因此，尿L-FABP是监测CKD的有用临床标志物。
To confirm the clinical usefulness of the measurement of urinary liver-type fatty acid-binding protein (L-FABP) in chronic kidney disease (CKD), we carried out a multicenter trial. Clinical markers were measured in patients with nondiabetic CKD (n = 48) every 1 to 2 months for a year. We divided patients retrospectively into progression (n = 32) and nonprogression (n = 16) groups on the basis of the rate of disease progression, then assessed several clinical markers. Initially creatinine clearance (Ccr) was similar in the 2 groups; however, the urinary L-FABP level was significantly higher in the former group than in the latter (111.5 vs 53 mu g/g creatinine, P < .001). For the monitoring CKD, we set the cutoff values for urinary L-FABP and urinary protein at 17.4 mu g/g creatinine and 1.0 g/g creatinine, respectively. Urinary L-FABP was more sensitive than urinary protein in predicting the progression of CKD (93.8% and 68.8%, respectively). However, urinary protein showed greater specificity than did urinary L-FABP (93.8% and 62.5%, respectively). Over time, the progression of CKD tended to correlate with changes in urinary L-FABP (r = -.32, P < .05), but not in urinary protein (r = .18, not significant). The dynamics of urinary protein differed from that of urinary L-FABP, which increased as Ccr declined. Urinary L-FABP is more sensitive than urinary protein in predicting the progression of CKD. Urinary excretion of L-FABP increases with the deterioration of kidney function. Urinary L-FABP is therefore a useful clinical marker in the monitoring of CKD.