THE ROLE OF SEVERAL BIOMARKERS IN ESTIMATION OF KIDNEY INJURY IN PATIENTS WITH PRIMARY GLOMERULOPATHIES

THE AIM: assessment of relationship between level of biomarkers and clinical and pathomorphological signs of glomerular, tubular sclerosis and tubular atrophy in patients with primary glomerular disease. PATIENTS AND METHODS. In cross-section study 71 patients hospitalized in department of nephrology with performed renal biopsies were included. According the results of light and electron microscopy 23 (32.4%) patients had IgA-nephropathy (mesangial proliferative glomerulonephritis), 14 (19.7%) – focal segmental glomerulosclerosis, 22 (31.0%) – membranous nephropathy, 12 (16,9%) – minimal change disease. Besides standard laboratory and instrumental investigations the level of serum cystatin-C and NGAL, urine cystatin-С, NGAL, nephrin were mesaured. Glomerulosclerosis, tubulointerstitial sclerosis and tubular atrophy were estimated quantitatively and semi quantitatively. RESULTS. GFR estimated using cystatin-C most accurately reflects the degree of glomerular sclerosis. Serum NGAL correlated with GFR estimated using cystatin-C and level of nephrinuria. Urine NGAL and tubular atrophy correlated as well; the rates of urine NGAL and cystatin-C excretion were the highest in patients with high range proteinuria. CONCLUSION. The applying of GFR estimated using cystatin-C is preferable in assessment of glomerulosclerosis degree. Urine NGAL excretion most accurately shows the severity of tubular atrophy while serum NGAL reflects the earliest stages of glomerular cell injury. Urine excretion of NGAL and cystatin-C depends on proteinuria and this fact should limit their exploitation in acute kidney injury diagnostics in patients with primary glomerulopathies and high range of proteinuria.

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