Correlation of serum sFlt-1,RBP,and MFG-E8 with residual renal function in patients with chronic kidney disease maintenance hemodialysis and their predictive value for prognosis
Objective To study the expression levels of serum soluble fms-like tyrosine kinase 1(sFlt-1),retinol-binding protein(RBP),and milk fat globule-epidermal growth factor-factor 8(MFG-E8)in patients with chronic kidney dis-ease maintenance hemodialysis,and to further analyze the correlation between the three with the residual renal function(RRF)of the patients,and their predictive value for prognosis.Methods From October 2020 to April 2023,168 chronic kid-ney disease maintenance hemodialysis patients admitted to our hospital were regarded as the diseased group,which were separated into the RRF group(n=28)and the no RRF group(n=140)according to the calculated value of RRF,and separa-ted into the survival group(n=128)and the death group(n=40)according to the prognosis.ELISA was applied to detect serum sFlt-1,RBP,and MFG-E8 levels.General clinical data were collected and analyzed.Spearman's method was applied to analyze the correlation between serum sFlt-1,RBP,MFG-E8 and RRF.Logistic regression was performed to analyze the fac-tors affecting patient prognosis.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum sFlt-1,RBP,and MFG-E8 levels for prognosis.Results Compared with the RRF group,the proportions of patients with diabetes mellitus in the no RRF group were greatly increased(x2/P=7.547/0.006),serum sFlt-1 and RBP levels were greatly higher(t/P=6.870/＜0.001、4.449/＜0.001),and MFGE8 level was greatly lower(t/P=14.071/＜0.001).Serum sFlt-1 and RBP were negatively correlated with RRF(r=-0.450,-0.562,P＜0.05),and MFG-E8 was positively correlated with RRF(r=0.556,P＜0.05).Compared with the survival group,serum sFlt-1 and RBP levels were greatly higher(P＜0.05)and MFG-E8 level was greatly lower(P＜0.05)in the death group.Diabetes,elevated serum sFlt-l and RBP levels were risk factors af-fecting prognosis(P＜0.05),and elevated MFG-E8 level was a protective factor affecting prognosis(P＜0.05).The AUC of serum sFlt-1,RBP,MFG-E8,and the combination for predicting prognosis was 0.834,0.836,0.825,and 0.925,respectively,and the combined prediction of the three was greatly better than that of sFlt-1(Z=2.757,P=0.006),RBP(Z=2.804,P=0.005),and MFG-E8(Z=3.035,P=0.002)alone.Conclusion Serum Flt-1 and RBP levels are greatly increased and MFG-E8 level is greatly decreased in chronic kidney disease maintenance hemodialysis patients without RRF,which had a certain correlation with RRF and had a certain auxiliary predictive value for the prognosis.
维普
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