Predictive value of combined detection of urine KIM-1, NGAL, and RBP for early renal injury in patients with chronic hepatitis B
Objective:To evaluate the predictive value of combined detection of urine KIM-1, NGAL, and RBP for early renal injury in patients with chronic hepatitis B.Methods:One hundred and thirty-three chronic hepatitis B patients admitted to Peking University People's Hospitalfrom January 2021 to July 2022 were included, and based on the urinary albumin/creatinin ratio (UACR), they were divided into either a non-injury group (UACR＜30 mg/g, 73 cases) or an injury group (UACR≥30 mg/g, 60 cases). Sixty healthy volunteers who underwent physical examination during the same period were selected as a control group. The urine levels of kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and retinol binding protein (RBP) were detected in the three groups. Clinical data were collected. The correlation of urine KIM-1, NGAL, and RBP with UACR was analyzed. The predictive value of urine KIM-1, NGAL, and RBP, either alone or in combination, for early renal injury in patients with chronic hepatitis B was assessed by ROC curve analysis.Results:The urine levels of KIM-1, NGAL, and RBP in the injury group were significantly higher than those of the non-injury group and control group (P＜0.05). There were no significant differences in urine KIM-1, NGAL, and RBP between the non-injury group and control group (P＞0.05). Urine KIM-1, NGAL, and RBP were positively correlated with UACR in chronic hepatitis B patients (r=0.589, 0.359, and 0.519, respectively, P＜0.05). ROC curve analysis showed that KIM-1, NGAL, and RBP had appreciated predictive value for early kidney injury in chronic hepatitis B patients; the area under the curve was 0.878, 0.761, and 0.870, the sensitivity was 73.33%, 48.33%, and 78.33%, and the specificity was 89.04%, 94.52%, and 84.93, respectively. The area under the curve, sensitivity (91.70%), and specificity (97.30%) of the three indexes combined were all significantly higher than those of any one of them alone (P＜0.05).Conclusion:Urinary KIM-1, NGAL, and RBP levels are significantly increased in patients with chronic hepatitis B during early renal injury, and combined detection of them has higher predictive value for early renal injury in such patients.
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