[A study on urine microglobulin change after interventional therapy of renal artery in patients with coronary heart disease].
OBJECTIVE
To evaluate the urine microglobulin change after interventional therapy in patients with renal artery stenosis.


METHODS
According to the results of renal artery angiography, 69 consecutive patients with coronary heart disease were divided into 2 groups, including 44 patients with severe renal artery stenosis RAS (luminal narrowing > 70%, group I) and 25 patients with atherosclerotic lesion in renal artery (luminal narrowing > 50% but < 70%, group II). The urine alpha(1), beta(2)-microglobulin (alpha(1), beta(2)-MG) were measured respectively. The successful procedural rates, rates of complication, serum creatitine and the urine alpha(1), beta(2)-MG 3 months after procedure were also recorded. The acute results and long-term follow-up outcomes were compared between the 2 groups.


RESULTS
Urine alpha(1)-MG [(5.2 +/- 2.5) microg/L vs (3.0 +/- 2.7) microg/L, P > 0.001] and beta(2)-MG [(377 +/- 173) microg/L vs (202 +/- 184) microg/L, P > 0.001] were significantly higher in group I than in group II. However, the urine alpha(1)-MG of the 2 groups did not exceed the normal range (<6 microg/L). The urine beta(2)-MG [(237 +/- 187) microg/L vs (377 +/- 173) microg/L, P > 0.01] 3 months after stenting procedure in group I were significantly decreased. There were no significance change in urine alpha(1)-MG in group I and both the microglobulins in group II during follow-up. There was significant difference in improvement of blood pressure between the 2 groups (62.5% vs 9.1%, P > 0.01). As compared with group II, group I patients had more re-admission (22.5% vs 9.1%), renal failure (5% vs 0) and higher mortality (5% vs 0). However, these measurements did not differ significantly. Multivariate analysis revealed that persistent elevation of urine beta(2)-MG was an independent predictor of severe events (including re-admission and renal failure) after renal artery stenting (OR = 3.01, 95% CI 1.01 - 8.95, P = 0.036).


CONCLUSIONS
Severe RAS causes damage of tubular reabsorption. Renal artery stenting improves tubular function, but in patients with persistent elevation of beta(2)-MG, the rates of re-admission and renal failure remain high.
Department of Cardiology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Jun
J
Ni
Wei-feng
WF
Shen
Rui-yan
RY
Zhang
Jian
J
Hu
Qi
Q
Zhang
Jing-yuan
JY
Xie
D000792:Angiography; D003327:Coronary Disease / Q000150:complications; D005500:Follow-Up Studies; D006801:Humans; D008562:Membrane Glycoproteins / Q000652:urine; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000150:complications / Q000601:surgery / Q000652:urine*; D014360:Trypsin Inhibitor, Kunitz Soybean / Q000652:urine; D001613:beta 2-Microglobulin / Q000652:urine*
D008562:Membrane Glycoproteins; C109148:SPINT2 protein, human; D001613:beta 2-Microglobulin; D014360:Trypsin Inhibitor, Kunitz Soybean