Диагностическое значение экскреции биомаркеров в оценке морфологических повреждений при первичных гломерулопатиях
Диагностическое значение экскреции биомаркеров в оценке морфологических повреждений при первичных гломерулопатиях
Саганова Е.С., Зубина И.М., Богданова Е.О., Галкина О.В., Сиповский В.Г., Смирнов А.В. Диагностическое значение экскреции биомаркеров в оценке морфологических повреждений при первичных гломерулопатиях. Терапевтический архив. 2021; 93 (6): 699–705. DOI: 10.26442/00403660.2021.06.200850
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Аннотация
Цель. Изучить диагностическую значимость биомаркеров в оценке степени выраженности склеротических и атрофических процессов в почечной паренхиме при первичных гломерулопатиях.
Материалы и методы. В исследование включены 100 пациентов. В 9 (9%) случаев выявлена болезнь минимальных изменений,
в 28 (28%) – фокально-сегментарный гломерулосклероз, в 26 (26%) – мембранозная нефропатия, в 37 (37%) – иммуноглобулин А-нефропатия. Проведены оценка клинического течения нефропатии, стандартные лабораторные исследования, определена суточная экскреция с мочой цистатина С, α1-микроглобулина, β2-микроглобулина и липокалина, ассоциированного с желатиназой нейтрофилов (NGAL). Степень выраженности гломерулосклероза оценивалась количественно, тубулоинтерстициального склероза и атрофии канальцев – полуколичественно.
Результаты. По результатам как линейного корреляционного, так и ROC-анализа экскреции цистатина С и α1-микроглобулина с мочой обладали диагностической значимостью в отношении ранних признаков тубулоинтерстициального склероза (пороговые уровни 319,9 и 10,94 мг/сут соответственно). Экскреция β2-микроглобулина отражала начальные проявления атрофии эпителия канальцев при пороговом значении 0,224 мкг/сут, а также склероз тубулоинтерстиция различной степени выраженности (пороговый уровень 0,224 и 0,240 мгк/сут). NGAL мочи являлся единственным маркером ранних проявлений гломерулосклероза при его экскреции более 1445,4 нг/сут и атрофии эпителия канальцев выраженностью 50% и более (пороговый уровень 4897,8 нг/сут).
Заключение. Комплексная оценка наличия склеротических и атрофических повреждений в почечной паренхиме может проводиться с использованием набора традиционных (скорость клубочковой фильтрации, уровень суточной протеинурии) и специфических биомаркеров (α1-, β2-микроглобулины, цистатин С, NGAL). Кроме того, оценка панели различных маркеров может быть использована и в тех клинических ситуациях, когда проведение нефробиопсии затруднено.
Ключевые слова: биомаркеры, протеинурия, цистатин С, α1-микроглобулин, β2-микроглобулин, NGAL, хроническая болезнь почек
Materials and methods. One hundred patients were included in the study, according to the results of kidney biopsy in 9 (9%) cases minimal change disease was diagnosed, in 28 (28%) – focal segmental glomerulosclerosis, in 26 (26%) – membranous nephropathy and in 37 (37%) – IgA nephropathy. The clinical course of nephropathy was evaluated, standard laboratory tests were performed, and urinary excretions of cystatin C, α1-microglobulin, β2-microglobulin and NGAL were measured. The degree of glomerulosclerosis was assessed quantitatively, tubulointerstitial sclerosis and tubular atrophy – semiquantitatively.
Results. According to the results of linear correlations and ROC-analysis, urinary excretion of cystatin C and α1-microglobulin had diagnostic value for early degree of tubulointerstitial sclerosis (cut-off value 319.9 and 10.94 mg/day, respectively). Urinary excretion of β2-microglobulin reflected the initial degree of tubalar atrophy (cut-off value of 0.224 mcg/day), as well as tubulointerstitial sclerosis of various degrees of severity (cut-off value 0.224 and 0.240 mkg/day). NGAL urinary excretion was the only marker of early degree of glomerulosclerosis with its excretion of more than 1445.4 ng/day and tubular atrophy, with a severity of 50% or more (cut-off value 4897.8 ng/day).
Conclusion. A comprehensive assessment of sclerotic and atrophic lesions in the renal parenchyma, can be performed using a panel of traditional (GFR, proteinuria) and specific biomarkers (α1-, β2-microglobulins, cystatin C, NGAL) to implement a comprehensive, personalized approach, as well as to assess the prognosis of nephropathy. In addition, the evaluation of the panel of different biomarkers can be used in those clinical situations where kidney biopsy can not be performed.
Keywords: biomarkers, proteinuria, cystatin C, α1-microglobulin, β2-microglobulin NGAL, chronic kidney disease
Материалы и методы. В исследование включены 100 пациентов. В 9 (9%) случаев выявлена болезнь минимальных изменений,
в 28 (28%) – фокально-сегментарный гломерулосклероз, в 26 (26%) – мембранозная нефропатия, в 37 (37%) – иммуноглобулин А-нефропатия. Проведены оценка клинического течения нефропатии, стандартные лабораторные исследования, определена суточная экскреция с мочой цистатина С, α1-микроглобулина, β2-микроглобулина и липокалина, ассоциированного с желатиназой нейтрофилов (NGAL). Степень выраженности гломерулосклероза оценивалась количественно, тубулоинтерстициального склероза и атрофии канальцев – полуколичественно.
Результаты. По результатам как линейного корреляционного, так и ROC-анализа экскреции цистатина С и α1-микроглобулина с мочой обладали диагностической значимостью в отношении ранних признаков тубулоинтерстициального склероза (пороговые уровни 319,9 и 10,94 мг/сут соответственно). Экскреция β2-микроглобулина отражала начальные проявления атрофии эпителия канальцев при пороговом значении 0,224 мкг/сут, а также склероз тубулоинтерстиция различной степени выраженности (пороговый уровень 0,224 и 0,240 мгк/сут). NGAL мочи являлся единственным маркером ранних проявлений гломерулосклероза при его экскреции более 1445,4 нг/сут и атрофии эпителия канальцев выраженностью 50% и более (пороговый уровень 4897,8 нг/сут).
Заключение. Комплексная оценка наличия склеротических и атрофических повреждений в почечной паренхиме может проводиться с использованием набора традиционных (скорость клубочковой фильтрации, уровень суточной протеинурии) и специфических биомаркеров (α1-, β2-микроглобулины, цистатин С, NGAL). Кроме того, оценка панели различных маркеров может быть использована и в тех клинических ситуациях, когда проведение нефробиопсии затруднено.
Ключевые слова: биомаркеры, протеинурия, цистатин С, α1-микроглобулин, β2-микроглобулин, NGAL, хроническая болезнь почек
________________________________________________
Materials and methods. One hundred patients were included in the study, according to the results of kidney biopsy in 9 (9%) cases minimal change disease was diagnosed, in 28 (28%) – focal segmental glomerulosclerosis, in 26 (26%) – membranous nephropathy and in 37 (37%) – IgA nephropathy. The clinical course of nephropathy was evaluated, standard laboratory tests were performed, and urinary excretions of cystatin C, α1-microglobulin, β2-microglobulin and NGAL were measured. The degree of glomerulosclerosis was assessed quantitatively, tubulointerstitial sclerosis and tubular atrophy – semiquantitatively.
Results. According to the results of linear correlations and ROC-analysis, urinary excretion of cystatin C and α1-microglobulin had diagnostic value for early degree of tubulointerstitial sclerosis (cut-off value 319.9 and 10.94 mg/day, respectively). Urinary excretion of β2-microglobulin reflected the initial degree of tubalar atrophy (cut-off value of 0.224 mcg/day), as well as tubulointerstitial sclerosis of various degrees of severity (cut-off value 0.224 and 0.240 mkg/day). NGAL urinary excretion was the only marker of early degree of glomerulosclerosis with its excretion of more than 1445.4 ng/day and tubular atrophy, with a severity of 50% or more (cut-off value 4897.8 ng/day).
Conclusion. A comprehensive assessment of sclerotic and atrophic lesions in the renal parenchyma, can be performed using a panel of traditional (GFR, proteinuria) and specific biomarkers (α1-, β2-microglobulins, cystatin C, NGAL) to implement a comprehensive, personalized approach, as well as to assess the prognosis of nephropathy. In addition, the evaluation of the panel of different biomarkers can be used in those clinical situations where kidney biopsy can not be performed.
Keywords: biomarkers, proteinuria, cystatin C, α1-microglobulin, β2-microglobulin NGAL, chronic kidney disease
Список литературы
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11. Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4(2):337-44. DOI:10.2215/CJN.03530708
12. Смирнов А.В., Хасун М., Каюков И.Г., и др. Уромодулин и выраженность тубулоинтерстициальных повреждений у пациентов с нефропатиями. Нефрология. 2015;19(2):49-54 [Smirnov AV, Khasun M, Kayukov IG, et al. Uromodulin and severity of tubulointerstitial lesions in patients with nephropathies. Nephrology. 2015;19(2):49-54 (in Russian)].
13. van den Brand JA, Hofstra JM, Wetzels JFM. Low-molecular-weight proteins as prognostic markers in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(12):2846-53. DOI:10.2215/CJN.04020411
14. Peters HPE, van den Brand JA, Wetzels JFM. Urinary excretion of low-molecular-weight proteins as prognostic markers in IgA nephropathy. Neth J Med. 2009;67(2):54-61
15. Kee YK, Yoon C-Y, Kim SJ, et al. Determination of the optimal target level of proteinuria in the management of patients with glomerular diseases by using different definitions of proteinuria. Medicine (Baltimore). 2017;96(44):e8154. DOI:10.1097/MD.0000000000008154
16. Кушнаренко Н.Н., Медведева Т.А., Говорин А.В., Мишко М.Ю. Цистатин С в диагностике преклинического поражения почек у больных с подагрой. Нефрология. 2018;22(1):75-82 [Kushnarenko NN, Medvedeva TA, Govorin AV, Mishko MY. Cystatin c in the diagnosis of pre-clinical kidney injury in patients with gout. Nephrology. 2018;22(1):75-82 (in Russian)]. DOI:10.24884/1561-6274-2018-22-1-75-82
17. Еремеева А.В., Длин В.В., Корсунский А.А., и др. Клиническое значение определения липокалина-2, ассоциированного с нейтрофильной желатиназой, у пациентов с хронической болезнью почек (обзор литературы). Нефрология. 2018;22(4):50-6 [Eremeeva AV, Dlin VV, Korsunsky AA, et al. Clinical significance of determination of lipocalin-2 associated with neutrophilic gelatinase in patients with chronic kidney disease (literature review). Nephrology. 2018;22(4):50-6 (in Russian)]. DOI:10.24884/1561-6274-2018-22-4-50-56
18. Reich HN, Troyanov S, Scholey JW, Cattran DC. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177-83. DOI:10.1681/ASN.2007050526
19. Bazzi C, Rizza V, Casellato D, et al. Fractional excretion of IgG in idiopathic membranous nephropathy with nephrotic syndrome:
a predictive marker of risk and drug responsiveness. BMC Nephrol. 2014;15:74. DOI:10.1186/1471-2369-15-74
20. Bazzi C, Petrini C, Rizza V, et al. Urinary excretion of IgG and alpha(1)-microglobulin predicts clinical course better than extent of proteinuria in membranous nephropathy. Am J Kidney Dis. 2001;38(2):240-8. DOI: 10.1053/ajkd.2001.26080
21. Branten AJW, Du Buf-Vereijken PW, Klasen IS, et al. Urinary excretion of beta2-microglobulin and IgG predict prognosis in idiopathic membranous nephropathy: a validation study. J Am Soc Nephrol. 2005;16(1):169-74. DOI:10.1681/ASN.2004040287
22. Shin JR, Kim SM, Yoo JS, et al. Urinary excretion of beta2-microglobulin as a prognostic marker in immunoglobulin A nephropathy. Korean J Intern Med. 2014;29(3):334-40. DOI:10.3904/kjim.2014.29.3.334
23. Nielsen R, Christensen EI, Birn H. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int. 2016;89(1):58-67. DOI:10.1016/j.kint.2015.11.007
24. Patel ML, Sachan R, Verma A, et al. Neutrophil gelatinase-associated lipocalin as a biomarker of disease progression in patients with chronic kidney disease. Indian J Nephrol. 2016;26(2):125-30. DOI:10.4103/0971-4065.157799
25. Patel ML, Sachan R, Misra R, et al. Prognostic significance of urinary NGAL in chronic kidney disease. Int J Nephrol Renovasc Dis. 2015;8:139-44. DOI:10.2147/IJNRD.S87423
26. Nickolas TL, Forster CS, Sise ME, et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int. 2012;82(6):718-22. DOI:10.1038/ki.2012.195
27. Ding H, He Y, Li K, et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for renal tubulointerstitial injury in IgA nephropathy. Clin Immunol. 2007;123(2):227-34. DOI:10.1016/j.clim.2007.01.010
28. Пролетов Я.Ю., Саганова Е.С., Галкина О.В., и др. Роль некоторых биомаркеров в оценке характера хронического повреждения почек у пациентов с первичными гломерулопатиями. Нефрология. 2013;17(1):60-9 [Proletov II, Saganova ES, Galkina OV, et al. The role of several biomarkers in estimation of kidney injury in patients with primary glomerulopathies. Nephrology. 2013;17(1):60-9 (in Russian)]. DOI:10.24884/1561-6274-2013-17-1-60-69
29. Rhee H, Shin N, Shin MJ, et al. High serum and urine neutrophil gelatinase-associated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy. Korean J Intern Med. 2015;30(3):354-61. DOI:10.3904/kjim.2015.30.3.354
2. Glassock RJ. Con: Kidney biopsy: an irreplaceable tool for patient management in nephrology. Nephrol Dial Transplant. 2015;30(4):528-31. DOI:10.1093/ndt/gfv044
3. Tan M, Li W, Zou G, et al. Clinicopathological features and outcomes of IgA nephropathy with hematuria and/or minimal proteinuria. Kidney Blood Press Res. 2015;40(2):200-6. DOI:10.1159/000368495
4. Ren H, Shen P, Li X, et al. Treatment and prognosis of primary focal segmental glomerulosclerosis. Contrib Nephrol. 2013;181:109-18. DOI:10.1159/000348468
5. Mischak H, Delles C, Vlahou A, Vanholder R. Proteomic biomarkers in kidney disease: issues in development and implementation. Nat Rev Nephrol. 2015;11(4):221-32. DOI:10.1038/nrneph.2014.247
6. Siwy J, Zürbig P, Argiles A, et al. Noninvasive diagnosis of chronic kidney diseases using urinary proteome analysis. Nephrol Dial Transplant. 2017;32(12):2079-89. DOI:10.1093/ndt/gfw337
7. Good DM, Zürbig P, Argilés A, et al. Naturally occurring human urinary peptides for use in diagnosis of chronic kidney disease. Mol Cell Proteomics. 2010;9(11):2424-37. DOI:10.1074/mcp.M110.001917
8. Gold L, Ayers D, Bertino J, et al. Aptamer-based multiplexed proteomic technology for biomarker discovery. PLoS One. 2010;5(12):e15004. DOI:10.1371/journal.pone.0015004
9. Proletov IaIu, Saganova ES, Galkina OV, et al. Diagnostic value of cystatin C and neutrophil gelatinase-associated lipocalin in primary glomerulopathies. Terapevticheskii Arkhiv (Ter. Arkh.). 2013;85(6):10-6 (in Russian)
10. Fassett RG, Venuthurupalli SK, Gobe GC, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: a review. Kidney Int. 2011;80(8):806-21. DOI:10.1038/ki.2011.198
11. Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4(2):337-44. DOI:10.2215/CJN.03530708
12. Smirnov AV, Khasun M, Kayukov IG, et al. Uromodulin and severity of tubulointerstitial lesions in patients with nephropathies. Nephrology. 2015;19(2):49-54 (in Russian)
13. van den Brand JA, Hofstra JM, Wetzels JFM. Low-molecular-weight proteins as prognostic markers in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(12):2846-53. DOI:10.2215/CJN.04020411
14. Peters HPE, van den Brand JA, Wetzels JFM. Urinary excretion of low-molecular-weight proteins as prognostic markers in IgA nephropathy. Neth J Med. 2009;67(2):54-61
15. Kee YK, Yoon C-Y, Kim SJ, et al. Determination of the optimal target level of proteinuria in the management of patients with glomerular diseases by using different definitions of proteinuria. Medicine (Baltimore). 2017;96(44):e8154. DOI:10.1097/MD.0000000000008154
16. Kushnarenko NN, Medvedeva TA, Govorin AV, Mishko MY. Cystatin c in the diagnosis of pre-clinical kidney injury in patients with gout. Nephrology. 2018;22(1):75-82 (in Russian) DOI:10.24884/1561-6274-2018-22-1-75-82
17. Eremeeva AV, Dlin VV, Korsunsky AA, et al. Clinical significance of determination of lipocalin-2 associated with neutrophilic gelatinase in patients with chronic kidney disease (literature review). Nephrology. 2018;22(4):50-6 (in Russian) DOI:10.24884/1561-6274-2018-22-4-50-56
18. Reich HN, Troyanov S, Scholey JW, Cattran DC. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177-83. DOI:10.1681/ASN.2007050526
19. Bazzi C, Rizza V, Casellato D, et al. Fractional excretion of IgG in idiopathic membranous nephropathy with nephrotic syndrome:
a predictive marker of risk and drug responsiveness. BMC Nephrol. 2014;15:74. DOI:10.1186/1471-2369-15-74
20. Bazzi C, Petrini C, Rizza V, et al. Urinary excretion of IgG and alpha(1)-microglobulin predicts clinical course better than extent of proteinuria in membranous nephropathy. Am J Kidney Dis. 2001;38(2):240-8. DOI: 10.1053/ajkd.2001.26080
21. Branten AJW, Du Buf-Vereijken PW, Klasen IS, et al. Urinary excretion of beta2-microglobulin and IgG predict prognosis in idiopathic membranous nephropathy: a validation study. J Am Soc Nephrol. 2005;16(1):169-74. DOI:10.1681/ASN.2004040287
22. Shin JR, Kim SM, Yoo JS, et al. Urinary excretion of beta2-microglobulin as a prognostic marker in immunoglobulin A nephropathy. Korean J Intern Med. 2014;29(3):334-40. DOI:10.3904/kjim.2014.29.3.334
23. Nielsen R, Christensen EI, Birn H. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int. 2016;89(1):58-67. DOI:10.1016/j.kint.2015.11.007
24. Patel ML, Sachan R, Verma A, et al. Neutrophil gelatinase-associated lipocalin as a biomarker of disease progression in patients with chronic kidney disease. Indian J Nephrol. 2016;26(2):125-30. DOI:10.4103/0971-4065.157799
25. Patel ML, Sachan R, Misra R, et al. Prognostic significance of urinary NGAL in chronic kidney disease. Int J Nephrol Renovasc Dis. 2015;8:139-44. DOI:10.2147/IJNRD.S87423
26. Nickolas TL, Forster CS, Sise ME, et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int. 2012;82(6):718-22. DOI:10.1038/ki.2012.195
27. Ding H, He Y, Li K, et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for renal tubulointerstitial injury in IgA nephropathy. Clin Immunol. 2007;123(2):227-34. DOI:10.1016/j.clim.2007.01.010
28. Proletov II, Saganova ES, Galkina OV, et al. The role of several biomarkers in estimation of kidney injury in patients with primary glomerulopathies. Nephrology. 2013;17(1):60-9 (in Russian) DOI:10.24884/1561-6274-2013-17-1-60-69
29. Rhee H, Shin N, Shin MJ, et al. High serum and urine neutrophil gelatinase-associated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy. Korean J Intern Med. 2015;30(3):354-61. DOI:10.3904/kjim.2015.30.3.354
2. Glassock RJ. Con: Kidney biopsy: an irreplaceable tool for patient management in nephrology. Nephrol Dial Transplant. 2015;30(4):528-31. DOI:10.1093/ndt/gfv044
3. Tan M, Li W, Zou G, et al. Clinicopathological features and outcomes of IgA nephropathy with hematuria and/or minimal proteinuria. Kidney Blood Press Res. 2015;40(2):200-6. DOI:10.1159/000368495
4. Ren H, Shen P, Li X, et al. Treatment and prognosis of primary focal segmental glomerulosclerosis. Contrib Nephrol. 2013;181:109-18. DOI:10.1159/000348468
5. Mischak H, Delles C, Vlahou A, Vanholder R. Proteomic biomarkers in kidney disease: issues in development and implementation. Nat Rev Nephrol. 2015;11(4):221-32. DOI:10.1038/nrneph.2014.247
6. Siwy J, Zürbig P, Argiles A, et al. Noninvasive diagnosis of chronic kidney diseases using urinary proteome analysis. Nephrol Dial Transplant. 2017;32(12):2079-89. DOI:10.1093/ndt/gfw337
7. Good DM, Zürbig P, Argilés A, et al. Naturally occurring human urinary peptides for use in diagnosis of chronic kidney disease. Mol Cell Proteomics. 2010;9(11):2424-37. DOI:10.1074/mcp.M110.001917
8. Gold L, Ayers D, Bertino J, et al. Aptamer-based multiplexed proteomic technology for biomarker discovery. PLoS One. 2010;5(12):e15004. DOI:10.1371/journal.pone.0015004
9. Пролетов Я.Ю., Саганова Е.С., Галкина О.В., и др. Диагностическая значимость цистатина С и нейтрофильного липокалина, ассоциированного с желатиназой, при первичных гломерулопатиях. Терапевтический архив. 2013;85(6):10-6 [Proletov IaIu, Saganova ES, Galkina OV, et al. Diagnostic value of cystatin C and neutrophil gelatinase-associated lipocalin in primary glomerulopathies. Terapevticheskii Arkhiv (Ter. Arkh.). 2013;85(6):10-6 (in Russian)].
10. Fassett RG, Venuthurupalli SK, Gobe GC, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: a review. Kidney Int. 2011;80(8):806-21. DOI:10.1038/ki.2011.198
11. Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4(2):337-44. DOI:10.2215/CJN.03530708
12. Смирнов А.В., Хасун М., Каюков И.Г., и др. Уромодулин и выраженность тубулоинтерстициальных повреждений у пациентов с нефропатиями. Нефрология. 2015;19(2):49-54 [Smirnov AV, Khasun M, Kayukov IG, et al. Uromodulin and severity of tubulointerstitial lesions in patients with nephropathies. Nephrology. 2015;19(2):49-54 (in Russian)].
13. van den Brand JA, Hofstra JM, Wetzels JFM. Low-molecular-weight proteins as prognostic markers in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(12):2846-53. DOI:10.2215/CJN.04020411
14. Peters HPE, van den Brand JA, Wetzels JFM. Urinary excretion of low-molecular-weight proteins as prognostic markers in IgA nephropathy. Neth J Med. 2009;67(2):54-61
15. Kee YK, Yoon C-Y, Kim SJ, et al. Determination of the optimal target level of proteinuria in the management of patients with glomerular diseases by using different definitions of proteinuria. Medicine (Baltimore). 2017;96(44):e8154. DOI:10.1097/MD.0000000000008154
16. Кушнаренко Н.Н., Медведева Т.А., Говорин А.В., Мишко М.Ю. Цистатин С в диагностике преклинического поражения почек у больных с подагрой. Нефрология. 2018;22(1):75-82 [Kushnarenko NN, Medvedeva TA, Govorin AV, Mishko MY. Cystatin c in the diagnosis of pre-clinical kidney injury in patients with gout. Nephrology. 2018;22(1):75-82 (in Russian)]. DOI:10.24884/1561-6274-2018-22-1-75-82
17. Еремеева А.В., Длин В.В., Корсунский А.А., и др. Клиническое значение определения липокалина-2, ассоциированного с нейтрофильной желатиназой, у пациентов с хронической болезнью почек (обзор литературы). Нефрология. 2018;22(4):50-6 [Eremeeva AV, Dlin VV, Korsunsky AA, et al. Clinical significance of determination of lipocalin-2 associated with neutrophilic gelatinase in patients with chronic kidney disease (literature review). Nephrology. 2018;22(4):50-6 (in Russian)]. DOI:10.24884/1561-6274-2018-22-4-50-56
18. Reich HN, Troyanov S, Scholey JW, Cattran DC. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177-83. DOI:10.1681/ASN.2007050526
19. Bazzi C, Rizza V, Casellato D, et al. Fractional excretion of IgG in idiopathic membranous nephropathy with nephrotic syndrome:
a predictive marker of risk and drug responsiveness. BMC Nephrol. 2014;15:74. DOI:10.1186/1471-2369-15-74
20. Bazzi C, Petrini C, Rizza V, et al. Urinary excretion of IgG and alpha(1)-microglobulin predicts clinical course better than extent of proteinuria in membranous nephropathy. Am J Kidney Dis. 2001;38(2):240-8. DOI: 10.1053/ajkd.2001.26080
21. Branten AJW, Du Buf-Vereijken PW, Klasen IS, et al. Urinary excretion of beta2-microglobulin and IgG predict prognosis in idiopathic membranous nephropathy: a validation study. J Am Soc Nephrol. 2005;16(1):169-74. DOI:10.1681/ASN.2004040287
22. Shin JR, Kim SM, Yoo JS, et al. Urinary excretion of beta2-microglobulin as a prognostic marker in immunoglobulin A nephropathy. Korean J Intern Med. 2014;29(3):334-40. DOI:10.3904/kjim.2014.29.3.334
23. Nielsen R, Christensen EI, Birn H. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int. 2016;89(1):58-67. DOI:10.1016/j.kint.2015.11.007
24. Patel ML, Sachan R, Verma A, et al. Neutrophil gelatinase-associated lipocalin as a biomarker of disease progression in patients with chronic kidney disease. Indian J Nephrol. 2016;26(2):125-30. DOI:10.4103/0971-4065.157799
25. Patel ML, Sachan R, Misra R, et al. Prognostic significance of urinary NGAL in chronic kidney disease. Int J Nephrol Renovasc Dis. 2015;8:139-44. DOI:10.2147/IJNRD.S87423
26. Nickolas TL, Forster CS, Sise ME, et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int. 2012;82(6):718-22. DOI:10.1038/ki.2012.195
27. Ding H, He Y, Li K, et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for renal tubulointerstitial injury in IgA nephropathy. Clin Immunol. 2007;123(2):227-34. DOI:10.1016/j.clim.2007.01.010
28. Пролетов Я.Ю., Саганова Е.С., Галкина О.В., и др. Роль некоторых биомаркеров в оценке характера хронического повреждения почек у пациентов с первичными гломерулопатиями. Нефрология. 2013;17(1):60-9 [Proletov II, Saganova ES, Galkina OV, et al. The role of several biomarkers in estimation of kidney injury in patients with primary glomerulopathies. Nephrology. 2013;17(1):60-9 (in Russian)]. DOI:10.24884/1561-6274-2013-17-1-60-69
29. Rhee H, Shin N, Shin MJ, et al. High serum and urine neutrophil gelatinase-associated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy. Korean J Intern Med. 2015;30(3):354-61. DOI:10.3904/kjim.2015.30.3.354
________________________________________________
2. Glassock RJ. Con: Kidney biopsy: an irreplaceable tool for patient management in nephrology. Nephrol Dial Transplant. 2015;30(4):528-31. DOI:10.1093/ndt/gfv044
3. Tan M, Li W, Zou G, et al. Clinicopathological features and outcomes of IgA nephropathy with hematuria and/or minimal proteinuria. Kidney Blood Press Res. 2015;40(2):200-6. DOI:10.1159/000368495
4. Ren H, Shen P, Li X, et al. Treatment and prognosis of primary focal segmental glomerulosclerosis. Contrib Nephrol. 2013;181:109-18. DOI:10.1159/000348468
5. Mischak H, Delles C, Vlahou A, Vanholder R. Proteomic biomarkers in kidney disease: issues in development and implementation. Nat Rev Nephrol. 2015;11(4):221-32. DOI:10.1038/nrneph.2014.247
6. Siwy J, Zürbig P, Argiles A, et al. Noninvasive diagnosis of chronic kidney diseases using urinary proteome analysis. Nephrol Dial Transplant. 2017;32(12):2079-89. DOI:10.1093/ndt/gfw337
7. Good DM, Zürbig P, Argilés A, et al. Naturally occurring human urinary peptides for use in diagnosis of chronic kidney disease. Mol Cell Proteomics. 2010;9(11):2424-37. DOI:10.1074/mcp.M110.001917
8. Gold L, Ayers D, Bertino J, et al. Aptamer-based multiplexed proteomic technology for biomarker discovery. PLoS One. 2010;5(12):e15004. DOI:10.1371/journal.pone.0015004
9. Proletov IaIu, Saganova ES, Galkina OV, et al. Diagnostic value of cystatin C and neutrophil gelatinase-associated lipocalin in primary glomerulopathies. Terapevticheskii Arkhiv (Ter. Arkh.). 2013;85(6):10-6 (in Russian)
10. Fassett RG, Venuthurupalli SK, Gobe GC, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: a review. Kidney Int. 2011;80(8):806-21. DOI:10.1038/ki.2011.198
11. Bolignano D, Lacquaniti A, Coppolino G, et al. Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009;4(2):337-44. DOI:10.2215/CJN.03530708
12. Smirnov AV, Khasun M, Kayukov IG, et al. Uromodulin and severity of tubulointerstitial lesions in patients with nephropathies. Nephrology. 2015;19(2):49-54 (in Russian)
13. van den Brand JA, Hofstra JM, Wetzels JFM. Low-molecular-weight proteins as prognostic markers in idiopathic membranous nephropathy. Clin J Am Soc Nephrol. 2011;6(12):2846-53. DOI:10.2215/CJN.04020411
14. Peters HPE, van den Brand JA, Wetzels JFM. Urinary excretion of low-molecular-weight proteins as prognostic markers in IgA nephropathy. Neth J Med. 2009;67(2):54-61
15. Kee YK, Yoon C-Y, Kim SJ, et al. Determination of the optimal target level of proteinuria in the management of patients with glomerular diseases by using different definitions of proteinuria. Medicine (Baltimore). 2017;96(44):e8154. DOI:10.1097/MD.0000000000008154
16. Kushnarenko NN, Medvedeva TA, Govorin AV, Mishko MY. Cystatin c in the diagnosis of pre-clinical kidney injury in patients with gout. Nephrology. 2018;22(1):75-82 (in Russian) DOI:10.24884/1561-6274-2018-22-1-75-82
17. Eremeeva AV, Dlin VV, Korsunsky AA, et al. Clinical significance of determination of lipocalin-2 associated with neutrophilic gelatinase in patients with chronic kidney disease (literature review). Nephrology. 2018;22(4):50-6 (in Russian) DOI:10.24884/1561-6274-2018-22-4-50-56
18. Reich HN, Troyanov S, Scholey JW, Cattran DC. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177-83. DOI:10.1681/ASN.2007050526
19. Bazzi C, Rizza V, Casellato D, et al. Fractional excretion of IgG in idiopathic membranous nephropathy with nephrotic syndrome:
a predictive marker of risk and drug responsiveness. BMC Nephrol. 2014;15:74. DOI:10.1186/1471-2369-15-74
20. Bazzi C, Petrini C, Rizza V, et al. Urinary excretion of IgG and alpha(1)-microglobulin predicts clinical course better than extent of proteinuria in membranous nephropathy. Am J Kidney Dis. 2001;38(2):240-8. DOI: 10.1053/ajkd.2001.26080
21. Branten AJW, Du Buf-Vereijken PW, Klasen IS, et al. Urinary excretion of beta2-microglobulin and IgG predict prognosis in idiopathic membranous nephropathy: a validation study. J Am Soc Nephrol. 2005;16(1):169-74. DOI:10.1681/ASN.2004040287
22. Shin JR, Kim SM, Yoo JS, et al. Urinary excretion of beta2-microglobulin as a prognostic marker in immunoglobulin A nephropathy. Korean J Intern Med. 2014;29(3):334-40. DOI:10.3904/kjim.2014.29.3.334
23. Nielsen R, Christensen EI, Birn H. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int. 2016;89(1):58-67. DOI:10.1016/j.kint.2015.11.007
24. Patel ML, Sachan R, Verma A, et al. Neutrophil gelatinase-associated lipocalin as a biomarker of disease progression in patients with chronic kidney disease. Indian J Nephrol. 2016;26(2):125-30. DOI:10.4103/0971-4065.157799
25. Patel ML, Sachan R, Misra R, et al. Prognostic significance of urinary NGAL in chronic kidney disease. Int J Nephrol Renovasc Dis. 2015;8:139-44. DOI:10.2147/IJNRD.S87423
26. Nickolas TL, Forster CS, Sise ME, et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int. 2012;82(6):718-22. DOI:10.1038/ki.2012.195
27. Ding H, He Y, Li K, et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is an early biomarker for renal tubulointerstitial injury in IgA nephropathy. Clin Immunol. 2007;123(2):227-34. DOI:10.1016/j.clim.2007.01.010
28. Proletov II, Saganova ES, Galkina OV, et al. The role of several biomarkers in estimation of kidney injury in patients with primary glomerulopathies. Nephrology. 2013;17(1):60-9 (in Russian) DOI:10.24884/1561-6274-2013-17-1-60-69
29. Rhee H, Shin N, Shin MJ, et al. High serum and urine neutrophil gelatinase-associated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy. Korean J Intern Med. 2015;30(3):354-61. DOI:10.3904/kjim.2015.30.3.354
Авторы
Е.С. Саганова*, И.М. Зубина, Е.О. Богданова, О.В. Галкина, В.Г. Сиповский, А.В. Смирнов
ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России
*nephrolog1985@gmail.com
Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
*nephrolog1985@gmail.com
ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России
*nephrolog1985@gmail.com
________________________________________________
Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
*nephrolog1985@gmail.com
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.