关键词: 糖尿病肾病；足细胞；酶联免疫吸附测定, 预后

Abstract: Objective  To investigate the correlation between nephrin and prognosis of patients with diabetic nephropathy(DN). Methods  Thirtytwo patients with DN underwent renal biopsy and were diagnosed.  Their nephrin in kidney was detected by direct immunofluorescence assay,  nephrin in urine was detected by  ELISA. The relationship of renal nephrin and urine nephrin and clinical prognosis were analyzed. Results  The expression of nephrin in the kidney of  DN group was significantly lower than that of normal group. The urinary nephrin/creatinine ratio in DN group was higher than that of normal group.  According to the level of nephrin in the kidney,  the patients were divided into two groups: high nephrin group and low nephrin group. The low nephrine group suffered longer duration of diabetes mellitus,  a higher level of glycosylated hemoglobin,  lower level of albumin and eGFR,  a higher level of urinary protein,  serum creatinine and urinary nephrin/creatinine excretion ratio (all  P<0.01). The low nephrin group showed more significant interstitial fibrosis,  tubular atrophy,  interstitial inflammation,  and arteriosclerosis(P<0.01). The increase of HbA1c was correlated with nephrin injury,  whereas the nephrin injury significantly correlated with the increase of urine protein and the decrease of eGFR.There was a significant difference in renal survival between the two groups (P<0.01). COX proportional hazards regression analysis showed that decreased nephrin expression in the kidney and increased nephrin excretion in urine significantly influence renal survival. Conclusion  The detection of nephrin in the kidney and urine of DN patients helps to  judge the condition and prognosis of DN.

Key words: diabetic nephropathy, podocytes, enzymelinked immunosorbent assay; , prognosis