The research relationship between urinary podocalyxin, nephrin and urinary protein in children with primary nephrotic syndrome

doi:10.3877/cma.j.issn.1673-5250.2015.04.016

Objective

To identify the relationships between proteinuria and foot process damage of primary nephrotic syndrome(NS).

Methods

From September 2013 to March 2014, a total of 20 patients with primary NS were selected as the research group(n=20) in Harbin Children's Hospital.Meanwhile 10 healthy children were selected as normal control group(n=10). The children in research group were treated with adrenal cortex hormone therapy.The levels of podocalyxin (PCX) and nephrin at different observation time in the nephropathy group and at random interval in normal control group were detected by enzyme-linked immunosorbent assay (ELISA) method.The serum levels of urine protein and urine creatinine were measured by the method of turbidimetric inhibition immuno assay and colorimetry.

Results

①The levels of urinary PCX, nephrin and urine protein/creatinine in research group were significantly higher than those of the normal control group(t=2.612, 2.843, 2.972; P<0.01). ②PCX, nephrin and urine protein/urine creatinine levels were decreased during the treatment in research group. There was no significant difference in urine PCX and nephrin between every couple of adjacent observation time (P>0.05). The levels of urinary PCX and nephrin were significantly decreased between the eighth day and before treatment, and the differences were statistically significant(t=1.934, 2.093; P<0.05). The levels of urinary protein/urine creatinine were significantly decreased between the sixth day and the forth day or before treatment, and the differences were also statistically significant(t=2.042, 2.120; P<0.05). ③PCX and nephrin levels were positively correlated with urine protein/urine creatinine levels (r=0.91, 0.92; P<0.01).

Conclusions

The levels of PCX and nephrin decreased with the recovery of NS, and it had a good correlation with urinary protein index, carrying on a quantitative detection of dynamic observation podocyte changes.It has certain clinical significance for judging the glomerular damage and recovery.

Key words: Nephritic, Proteinuria, Podocyte, Podocalyxin, Nephrin

表1 两组儿童尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

组别	例数	PCX(ng/mL)	Nephrin(ng/mL)	尿蛋白/尿肌酐
肾病组	20	9.34±2.14	8.99±0.62	7.47±2.82
正常对照组	10	3.89±0.44	2.53±0.46	0.21±0.18
t值		2.612	2.843	2.972
P值		<0.01	<0.01	<0.01

表1 两组儿童尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

组别	例数	PCX(ng/mL)	Nephrin(ng/mL)	尿蛋白/尿肌酐
肾病组	20	9.34±2.14	8.99±0.62	7.47±2.82
正常对照组	10	3.89±0.44	2.53±0.46	0.21±0.18
t值		2.612	2.843	2.972
P值		<0.01	<0.01	<0.01

表2 儿童肾病恢复期尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

观察指标(尿液)	观察时间点
观察指标(尿液)	治疗前	第2天	第4天	第6天	第8天
PCX(ng/mL)^a	9.34±2.14	9.31±2.23	9.02±2.29	8.35±2.60	6.87±2.27^b
Nephrin(ng/mL)^a	8.99±0.62	8.79±0.73	8.53±0.97	7.93±0.86	6.52±1.41^b
尿蛋白/尿肌酐比值	7.47±2.82	6.90±3.12	5.03±2.98	2.83±1.20^c	1.55±0.79

表2 儿童肾病恢复期尿PCX、nephrin水平及尿蛋白、尿肌酐比值比较(±s)

观察指标(尿液)	观察时间点
观察指标(尿液)	治疗前	第2天	第4天	第6天	第8天
PCX(ng/mL)^a	9.34±2.14	9.31±2.23	9.02±2.29	8.35±2.60	6.87±2.27^b
Nephrin(ng/mL)^a	8.99±0.62	8.79±0.73	8.53±0.97	7.93±0.86	6.52±1.41^b
尿蛋白/尿肌酐比值	7.47±2.82	6.90±3.12	5.03±2.98	2.83±1.20^c	1.55±0.79

图1 儿童肾病不同观察时刻尿PCX、nephrin水平和尿蛋白/尿肌酐比值比较

图2 尿PCX与尿蛋白/尿肌酐直线相关分析

图3 尿nephrin与尿蛋白/尿肌酐直线相关分析

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