An Evaluation of Renal Function in Patients with Hydronephrosis by Multi-index Combination
Objective To explore the diagnostic value of 99Tcm-DTPA renal dynamic imaging,non-contrast CT and the levels of serum klotho,β2-microglobulin(β2-MG)on renal function in patients with hydronephrosis.Methods We selected 97 patients with hydronephrosis who visited our hospital from January,2023 to January,2024 as the hydronephrosis group.According to the grade of hydronephrosis derived from imaging data,these patients were divided into the mild group(40 cases),moderate group(30 cases),and severe group(27 cases).In addition,50 healthy individuals who underwent physical examination were included as the normal group during the same period.99Tcm-DTPA renal dynamic imaging was performed on all subjects to calculate GFR.The thickness of renal parenchyma was analyzed by non-contrast CT.Fully automated biochemical analyzer was applied to detect serum β2-MG level.Enzyme linked immunosorbent assay was performed to detect serum Klotho level.Pearson method was applied to analyze the correlation between GFR,renal parenchymal thickness and Klotho,β2-MG.Multivariate logistic regression was applied to identify potential impact factors affecting renal function in patients with hydronephrosis.ROC curve was drawn to evaluate the diagnostic value of nuclide renal dynamic imaging,non-contrast CT Klotho,and β2-MG levels for renal function in patients with hydronephrosis.Results The GFR,renal parenchymal thickness and serum Klotho levels in the hydronephrosis group were significantly lower than those in the normal group,while the β2-MG level was significantly higher than that in the normal group(P＜0.05).The GFR,renal parenchymal thickness and serum Klotho levels decreased sequentially in the mild,moderate,and severe groups,while the level of β2-MG increased sequentially(P＜0.05).GFR was positively correlated with renal parenchymal thickness and Klotho level(r=0.436,0.502,P＜0.05),while negatively correlated with β2-MG level(r=-0.394,P＜0.05).Klotho level was positively correlated with renal parenchymal thickness(r=0.404,P＜0.05),while negatively correlated with β2-MG level(r=-0.413,P＜0.05).β2-MG level was negatively correlated with renal parenchymal thickness(r=-0.471,P＜0.05).GFR,renal parenchymal thickness and Klotho were protective factors affecting renal function in patients with hydronephrosis,while β2-MG was a risk factor(P＜0.05).The AUC of GFR,Renal parenchymal thickness combined with Klotho and β2-MG level in diagnosing renal function in patients with hydronephrosis was 0.992,which was better than single-indicator diagnoses(ZGFR-combination=2.673,P=0.008;ZRenal parenchymal thickness-combination=4.807,P＜0.001;ZKlotho-combination=3.511,P＜0.05;Zβ2 MG-combination=3.932,P＜0.05),with sensitivity and specificity of 96.49％and 87.18％,respectively.Conclusion GFR,renal parenchymal thickness and Klotho levels are down regulated,while β2-MG is up regulated in patients with hydronephrosis.The combination of 99Tcm-DTPA renal dynamic imaging,non-contrast CT and Klotho and β2-MG could have a good diagnostic value for renal function in patients with hydronephrosis.
万方数据
维普
