The diagnostic significances of urine KIM-1 and NGAL in hypertensive renal damage

Objective To investigate the expression and significance of urine kidney injury molecule- 1(KIM-1) and neutrophil gelatinases associated lipocalin( NGAL) in hypertensive renal damage with different degree of albuminuria. Methods Sixty- eight patients with primary hypertension were selected. According to the urinary albumin / creatinine ratio( ACR),they were divided into normal albuminuria group( NA,n = 19),microalbuminuria group( MA,n =24),and clinical albuminuria group( CA,n = 22). Fourteen healthy persons were enrolled as normal controls. Serum creatinine,urine creatinine and urine albumin were recorded for calculation of ACR. According to MDRD formula,GFR was also calculated. Blood pressure was monitored and the mean arterial pressure( MAP) was calculate. By ELISA method,urine NGAL and KIM- 1 were assessed,and the test results were presented with urine NGAL and KIM- 1 divided by urine creatinine as the final results. Results The levels of e GFR and MAP were significantly increased with the increase of proteinuria in each hypertension groups,there was statistical significance among the 3 groups( P 0. 05); but there was no significant difference in e GFR between NA group and normal control group. Urine NGAL / Cr and KIM- 1 / Cr were increased with the increase of proteinuria in each hypertension groups,there was statistical significance among the 3 groups(P 0. 05). In correlation analysis,the urine NGAL/Cr was positively correlated with ACR and MAP,negatively correlated with e GFR; the urine KIM- 1 / Cr was positively correlated with ACR and negatively correlated with e GFR. Conclusion The urine NGAL and KIM- 1 may be useful to assess early hypertensive kidney injury prior to microalbuminuria.Moreover,NGAL can evaluate the blood pressure control,with predictive value on the hypertension- induced damage of other organs.