Urinary retinol-binding protein as a risk factor of poor prognosis in acute-on-chronic renal injury

作者:Yuan, Yanhong; Wang, Chunlin; Shao, Xinghua; Wang, Qin; Che, Xiajing; Zhang, Minfang; Xie, Yuanyuan; Tian, Lei; Ni, Zhaohui; Mou, Shan*
来源:Journal of Nephrology, 2016, 29(6): 827-833.
DOI:10.1007/s40620-016-0331-4

摘要

Background Acute-on-chronic renal injury was commonly seen in clinical practice. Reversibility of acute-on-chronic renal injury had not yet been carefully explored. This study tested whether urinary biomarkers could be used as a noninvasive prognostic marker in patients with acute-on-chronic renal injury. @@@ Methods 108 adult patients with pre-existing chronic kidney disease presenting with acute-on-chronic renal injury were included. Urinary retinol-binding protein (uRBP), N-Acetyl-b-d-Glucosaminidase (uNAG) and albumin (uALB) was quantified. @@@ Results Reversibility of renal function was achieved in 43 patients of the 108 included patients. The levels of urinary retinol-binding protein, N-Acetyl-b-d-Glucosaminidase and albumin for non-recovery acute-on-chronic renal injury patients were much higher than recovery patients. The fourth quartiles of urinary retinol-binding protein were significantly associated with at least 1.055-fold odds of non-recovery and the urinary retinol-binding protein was an independent risk factor for outcome of acute-on-chronic renal injury patients by multivariate logistic regression analysis. Quartiles of both urinary N-Acetyl-b-d-Glucosaminidase and albumin had a graded relationship with the risk for un-recovery AKI. However, after a multivariate logistic analysis, the urinary N-Acetyl-b-d-Glucosaminidase and albumin was not associated with reversibility of acute-on-chronic renal injury. @@@ Conclusion In patients with acute-on-chronic renal injury, urinary retinol-binding protein was associated with the reversibility of kidney function. Quantification of urinary retinol-binding protein may be developed as a non-invasive tool for predicting outcome of acute-on-chronic renal injury patients.