Panel of serum biomarkers for non-invasive assessment of glomerular and tubular injury in patients with chronic glomerulonephritis with and without arterial hypertension
Abstract
Aim: to analyze histological kidney features in patients with chronic glomerulonephritis (CGN) with and without arterial hypertension (AH) and to assess the relationship between serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), and interleukin-18 (IL-18) levels and histological signs of glomerular and tubulointerstitial kidney injury in patients with preserved renal function. Material and methods. This observational study included 219 patients with biopsy-proven CGN and preserved renal function. Patients were stratified into two groups: CGN with AH (n = 149) and CGN without AH (n = 70). A control group consisted of 60 apparently healthy individuals. Serum levels of cystatin C, NGAL, and IL-18 were measured using enzyme-linked immunosorbent assay. Renal biopsy specimens were evaluated using standard semi-quantitative criteria. Statistical analyses included group comparisons, Spearman’s rank correlation and receiver operating characteristic curve analysis. Results. Patients with CGN and AH demonstrated significantly higher serum levels of IL-18, cystatin C, and NGAL compared with patients without AH and controls (p < 0.05). Median IL-18 levels were highest in the CGN with AH group, followed by the CGN without AH group and controls. Similar patterns were observed for cystatin C and NGAL. Serum cystatin C levels correlated with histological markers of glomerular injury, whereas NGAL and IL-18 were associated with tubulointerstitial damage. Biomarker elevations were more pronounced in patients with concomitant AH. Conclusions. A serum multimarker approach combining cystatin C, NGAL, and IL-18 effectively reflects compartment-specific glomerular and tubulointerstitial kidney injury in patients with CGN and preserved renal function. Arterial hypertension significantly enhances biomarker expression and structural kidney damage, supporting the clinical value of multimarker strategies for non-invasive assessment of renal injury in CGN.